心血管康复医学杂志
心血管康複醫學雜誌
심혈관강복의학잡지
JOURNAL OF CARDIOVASCULAR REHABILITATION MEDICINE
2015年
4期
376-379
,共4页
脑梗死%冠心病%冠状血管造影术
腦梗死%冠心病%冠狀血管造影術
뇌경사%관심병%관상혈관조영술
Brain infarction%Coronary disease%Coronary angiography
目的:探讨冠心病(CHD)与无症状性脑梗死(SBI)之间的关系。方法:随机选择行冠脉造影检查患者430例,其中 CHD 患者330例,非 CHD 患者100例。根据头颅 MRI 扫描结果是否合并 SBI,CHD 患者被分为CHD 合并 SBI 组(208例)和 CHD 无 SBI 组(122例)。检测所有患者的超敏 C 反应蛋白(hsCRP)、血同型半胱氨酸(Hcy)指标,并计算冠状动脉病变评分(CAS)和 Gensini 评分(GS)。结果:CHD 患者中合并 SBI 发生率明显高于非 CHD 患者(63%比31%,P <0.01);与 CHD 无 SBI 组比较,CHD 合并 SBI 组的年龄明显较大[(60.79±9.65)岁比(67.14±9.77)岁],高血压(41.0%比66.8%)、高血脂症病史(37.7%比55.8%)比例明显增大,hsCRP [(3.92±2.17)g/L 比(5.85±6.27)g/L]、Hcy [(9.20±3.20)μmol/L 比(10.54±4.25)μmol/L]水平明显升高,CAS [(0.88±0.88)分比(1.94±0.94)分]和 GS [(18.62±16.23)分比(53.04±39.61)分]评分明显增加,伴有冠脉左前降支狭窄比例(25.4%比69.2%)明显增大,P 均<0.01;Logistic 回归分析显示,SBI 的危险因素为年龄(OR=1.07,95%CI:1.032~1.108)、高血压病史(OR=2.195,95%CI:1.104~4.366)、Hcy (OR=1.088,95%CI:1.001~1.182)、CAS (OR=1.776,95%CI:1.049~3.007)、GS (OR =1.039,95%CI:1.013~1.066),P <0.05或<0.01。结论:冠心病患者无症状性脑梗死(SBI)发生率较非冠心病者高;冠脉病变越严重,合并 SBI 比例越大。冠脉造影评分和 Gensini 评分异常提示可能存在 SBI。
目的:探討冠心病(CHD)與無癥狀性腦梗死(SBI)之間的關繫。方法:隨機選擇行冠脈造影檢查患者430例,其中 CHD 患者330例,非 CHD 患者100例。根據頭顱 MRI 掃描結果是否閤併 SBI,CHD 患者被分為CHD 閤併 SBI 組(208例)和 CHD 無 SBI 組(122例)。檢測所有患者的超敏 C 反應蛋白(hsCRP)、血同型半胱氨痠(Hcy)指標,併計算冠狀動脈病變評分(CAS)和 Gensini 評分(GS)。結果:CHD 患者中閤併 SBI 髮生率明顯高于非 CHD 患者(63%比31%,P <0.01);與 CHD 無 SBI 組比較,CHD 閤併 SBI 組的年齡明顯較大[(60.79±9.65)歲比(67.14±9.77)歲],高血壓(41.0%比66.8%)、高血脂癥病史(37.7%比55.8%)比例明顯增大,hsCRP [(3.92±2.17)g/L 比(5.85±6.27)g/L]、Hcy [(9.20±3.20)μmol/L 比(10.54±4.25)μmol/L]水平明顯升高,CAS [(0.88±0.88)分比(1.94±0.94)分]和 GS [(18.62±16.23)分比(53.04±39.61)分]評分明顯增加,伴有冠脈左前降支狹窄比例(25.4%比69.2%)明顯增大,P 均<0.01;Logistic 迴歸分析顯示,SBI 的危險因素為年齡(OR=1.07,95%CI:1.032~1.108)、高血壓病史(OR=2.195,95%CI:1.104~4.366)、Hcy (OR=1.088,95%CI:1.001~1.182)、CAS (OR=1.776,95%CI:1.049~3.007)、GS (OR =1.039,95%CI:1.013~1.066),P <0.05或<0.01。結論:冠心病患者無癥狀性腦梗死(SBI)髮生率較非冠心病者高;冠脈病變越嚴重,閤併 SBI 比例越大。冠脈造影評分和 Gensini 評分異常提示可能存在 SBI。
목적:탐토관심병(CHD)여무증상성뇌경사(SBI)지간적관계。방법:수궤선택행관맥조영검사환자430례,기중 CHD 환자330례,비 CHD 환자100례。근거두로 MRI 소묘결과시부합병 SBI,CHD 환자피분위CHD 합병 SBI 조(208례)화 CHD 무 SBI 조(122례)。검측소유환자적초민 C 반응단백(hsCRP)、혈동형반광안산(Hcy)지표,병계산관상동맥병변평분(CAS)화 Gensini 평분(GS)。결과:CHD 환자중합병 SBI 발생솔명현고우비 CHD 환자(63%비31%,P <0.01);여 CHD 무 SBI 조비교,CHD 합병 SBI 조적년령명현교대[(60.79±9.65)세비(67.14±9.77)세],고혈압(41.0%비66.8%)、고혈지증병사(37.7%비55.8%)비례명현증대,hsCRP [(3.92±2.17)g/L 비(5.85±6.27)g/L]、Hcy [(9.20±3.20)μmol/L 비(10.54±4.25)μmol/L]수평명현승고,CAS [(0.88±0.88)분비(1.94±0.94)분]화 GS [(18.62±16.23)분비(53.04±39.61)분]평분명현증가,반유관맥좌전강지협착비례(25.4%비69.2%)명현증대,P 균<0.01;Logistic 회귀분석현시,SBI 적위험인소위년령(OR=1.07,95%CI:1.032~1.108)、고혈압병사(OR=2.195,95%CI:1.104~4.366)、Hcy (OR=1.088,95%CI:1.001~1.182)、CAS (OR=1.776,95%CI:1.049~3.007)、GS (OR =1.039,95%CI:1.013~1.066),P <0.05혹<0.01。결론:관심병환자무증상성뇌경사(SBI)발생솔교비관심병자고;관맥병변월엄중,합병 SBI 비례월대。관맥조영평분화 Gensini 평분이상제시가능존재 SBI。
Objective:To explore the relationship between coronary heart disease (CHD)and silent brain infarction (SBI).Methods:A total of 430 patients who had received coronary angiography were enrolled,including 330 CHD patients and 100 non-CHD patients.According to complicated with SBI or not scanned by cranial MRI,CHD pa-tients were divided into CHD+SBI group (n=208)and CHD without SBI group (pure CHD group,n=122).Levels of high sensitive C reactive protein (hsCRP)and homocysteine (Hcy)were measured,and coronary artery score (CAS)and Gensini score (GS)were calculated in all patients.Results:Incidence rate of complicated SBI in CHD patients was significantly higher than that of non-CHD patients (63% vs.31%,P <0.01);compared with pure CHD group,there were significant rise in age [(60.79±9.65)years vs.(67.14±9.77)years],percentages of hy-pertension (41.0% vs.66.8%),hyperlipidemia (37.7% vs.55.8%)and levels of hsCRP [(3.92±2.17)g/L vs. (5.85±6.27)g/L],Hcy [(9.20±3.20)μmol/L vs.(10.54±4.25)μmol/L],CAS [(0.88±0.88)scores vs. (1.94±0.94)scores]and GS [(18.62±16.23)scores vs.(53.04±39.61)scores],and percentage of left anterior descending artery stenosis (25.4% vs.69.2%)in CHD+SBI group,P <0.01;Logistic regression analysis indicated that risk factors of SBI were age (OR=1.07,95%CI:1.032~1.108),hypertension history (OR=2.195,95%CI:1.104~4.366),Hcy (OR=1.088,95%CI:1.001~1.182),CAS (OR=1.776,95%CI:1.049~3.007)and GS (OR =1.039,95%CI:1.013~ 1.066),P <0.05 or <0.01. Conclusion:Incidence rate of SBI in CHD pa-tients is significantly higher than that of non-CHD patients;the more severe coronary artery disease is,the higher percentage of complicated SBI is.CAS and Gensini score abnormities suggest there may be SBI existence simultaneously.