中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
2期
127-131
,共5页
席鹏丽%张云强%郭牧%贾志%梁海青%宋昱
席鵬麗%張雲彊%郭牧%賈誌%樑海青%宋昱
석붕려%장운강%곽목%가지%량해청%송욱
急性冠状动脉综合征%侧支循环%规律运动%冠状动脉病变%Rentrop分级
急性冠狀動脈綜閤徵%側支循環%規律運動%冠狀動脈病變%Rentrop分級
급성관상동맥종합정%측지순배%규률운동%관상동맥병변%Rentrop분급
Coronary artery disease%Coronary collateral%Regular exercise%Coronary artery lesion%Rentrop grading system
目的 探讨急性冠状动脉综合征(ACS)患者发病前规律运动与冠状动脉侧支循环的关系.方法 选择2012年5-10月入院确诊为ACS并经冠状动脉造影检查为严重冠状动脉病变的239例患者为研究对象,按是否规律运动分为规律运动组102例与无规律运动组137例,收集分析冠状动脉造影及其他相关指标结果,并进行冠状动脉病变Gemini积分和侧支循环Rentmp分级,比较两组间冠状动脉侧支循环情况,同时对其他临床和实验室特征进行比较,采用多元logistic回归分析与侧支循环形成的关联因素.结果 规律运动组侧支循环形成比例[41.2％ (42/102)]高于无规律运动组[24.1％(33/137)],差异有统计学意义(x2=7.929,P=0.005);规律运动组lg(Gensini评分)为(1.89±0.18)分,非规律运动组为(1.94±0.19)分,差异有统计学意义(t=2.003,P=0.046);两组左心室射血分数分别为57.0％ (52.0％,60.0％)、50.0％ (45.0％,57.0％),差异有统计学意义(Z=-5.152,P=0.000).多因素Logistic回归分析显示,规律运动(OR=3.423,95％ CI:1.790～6.548)、糖尿病(OR=0.451,95％CI:0.212 ～0.962)、B型脑钠肽(OR=2.412,95％ CI:1.271 ～4.578)、非ST段抬高型ACS(OR=2.383,95％ CI:1.185～4.791)、胸痛史(OR =2.207,95％ CI:1.175～4.145)、Gensini评分(OR=1.538,95％ CI:1.141～2.073)是侧支循环建立的影响因素(P均＜0.05).调整其他影响因素后,与无规律运动比较,规律运动的患者更容易形成冠状动脉侧支循环(OR=3.423,95％ CI:1.790～6.548,P＜0.001).结论 对于ACS患者,规律运动有利于侧支循环的形成.
目的 探討急性冠狀動脈綜閤徵(ACS)患者髮病前規律運動與冠狀動脈側支循環的關繫.方法 選擇2012年5-10月入院確診為ACS併經冠狀動脈造影檢查為嚴重冠狀動脈病變的239例患者為研究對象,按是否規律運動分為規律運動組102例與無規律運動組137例,收集分析冠狀動脈造影及其他相關指標結果,併進行冠狀動脈病變Gemini積分和側支循環Rentmp分級,比較兩組間冠狀動脈側支循環情況,同時對其他臨床和實驗室特徵進行比較,採用多元logistic迴歸分析與側支循環形成的關聯因素.結果 規律運動組側支循環形成比例[41.2％ (42/102)]高于無規律運動組[24.1％(33/137)],差異有統計學意義(x2=7.929,P=0.005);規律運動組lg(Gensini評分)為(1.89±0.18)分,非規律運動組為(1.94±0.19)分,差異有統計學意義(t=2.003,P=0.046);兩組左心室射血分數分彆為57.0％ (52.0％,60.0％)、50.0％ (45.0％,57.0％),差異有統計學意義(Z=-5.152,P=0.000).多因素Logistic迴歸分析顯示,規律運動(OR=3.423,95％ CI:1.790～6.548)、糖尿病(OR=0.451,95％CI:0.212 ～0.962)、B型腦鈉肽(OR=2.412,95％ CI:1.271 ～4.578)、非ST段抬高型ACS(OR=2.383,95％ CI:1.185～4.791)、胸痛史(OR =2.207,95％ CI:1.175～4.145)、Gensini評分(OR=1.538,95％ CI:1.141～2.073)是側支循環建立的影響因素(P均＜0.05).調整其他影響因素後,與無規律運動比較,規律運動的患者更容易形成冠狀動脈側支循環(OR=3.423,95％ CI:1.790～6.548,P＜0.001).結論 對于ACS患者,規律運動有利于側支循環的形成.
목적 탐토급성관상동맥종합정(ACS)환자발병전규률운동여관상동맥측지순배적관계.방법 선택2012년5-10월입원학진위ACS병경관상동맥조영검사위엄중관상동맥병변적239례환자위연구대상,안시부규률운동분위규률운동조102례여무규률운동조137례,수집분석관상동맥조영급기타상관지표결과,병진행관상동맥병변Gemini적분화측지순배Rentmp분급,비교량조간관상동맥측지순배정황,동시대기타림상화실험실특정진행비교,채용다원logistic회귀분석여측지순배형성적관련인소.결과 규률운동조측지순배형성비례[41.2％ (42/102)]고우무규률운동조[24.1％(33/137)],차이유통계학의의(x2=7.929,P=0.005);규률운동조lg(Gensini평분)위(1.89±0.18)분,비규률운동조위(1.94±0.19)분,차이유통계학의의(t=2.003,P=0.046);량조좌심실사혈분수분별위57.0％ (52.0％,60.0％)、50.0％ (45.0％,57.0％),차이유통계학의의(Z=-5.152,P=0.000).다인소Logistic회귀분석현시,규률운동(OR=3.423,95％ CI:1.790～6.548)、당뇨병(OR=0.451,95％CI:0.212 ～0.962)、B형뇌납태(OR=2.412,95％ CI:1.271 ～4.578)、비ST단태고형ACS(OR=2.383,95％ CI:1.185～4.791)、흉통사(OR =2.207,95％ CI:1.175～4.145)、Gensini평분(OR=1.538,95％ CI:1.141～2.073)시측지순배건립적영향인소(P균＜0.05).조정기타영향인소후,여무규률운동비교,규률운동적환자경용역형성관상동맥측지순배(OR=3.423,95％ CI:1.790～6.548,P＜0.001).결론 대우ACS환자,규률운동유리우측지순배적형성.
Objective To investigate the relationship between regular exercise habit and coronary collaterals of patients with acute coronary syndrome (ACS).Methods TWo hundred and thirty-night patients diagnosed ACS and operated coronary angiography (CAG) showing severe coronary stenosis were enrolled hospitalized from May 2012 to October 2012.They were divided into regular exercise group (n =102) and irregular exercise group(n =137) according to the exercise frequency.The information of the general data,the information of CAG and other relevant index were collected.The coronary artery score was recorded according to the Censini and the coronary collateral class was made according to the Rentrop.Other characters in clinical and laboratory were recorded.Multi-factor regression analysis was used to analysis the influence factors of coronary collateral.Results The proportion of coronary collaterals (41.2％ (42/102)) in the regular exercise group was higher than that in the irregular exercise group (24.1％ (33/137)),and the difference was statistically significant(x2 =7.929,P =0.005).Lg(Gensini score) was (1.89 ± 0.18) the and (1.94 ± 0.19) in the regular exercise group,The left ventricular ejection fraction was 57.0％ (52.0％,60.0％) in the regular exercise group and 50.0％ (45.0％,57.0％) in the irregular exercise group,and the difference was statistically significant (Z =-5.152,P =0.000).Multi-factor regression analysis showed that regular exercise (OR =3.423,95％ CI:1.790-4.578),diabetes mellitus (OR =0.451,95％ CI:0.212-0.962),B-type natriuretic peptide (OR =2.412,95 ％ CI:1.271-4.578),non-ST-segment elevation ACS (OR =2.383,95％ CI:1.185-4.791),chest pain history (OR =2.207,95％ CI:1.175-4.145),Gensini score (OR =1.538,95％ CI:1.141-2.073) were independent influence factors of coronary collateral(P ＜ 0.05).After adjusting other factors,the patients with regular exercise had better coronary collaterals than that with irregular exercise (OR=3.423,95％CI:1.790-6.548,P ＜0.001).Conclusion The regular exercise can promote coronary collateral emergence for the patients with ACS.
