男性早发冠心病冠状动脉病变特点和危险因素的研究 - 第三军医大学学报.doc

男性早发冠心病冠状动脉病变特点和危险因素的研究 陈君 郭志刚 胡威 修建成 周忠江 南方医科大学南方医院心内科，广东 广州510515 【摘要】　目的　对男性早发冠心病患者心血管疾病危险因素及冠状动脉造影病变特点的研究。方法　448例经冠状动脉造影确诊为冠心病的男性患者，按年龄分为早发组145例(男性＜55岁)和晚发组(男性≥55岁)303例，对两组患者的危险因素及冠状动脉病变特点进行统计学比较，并应用多因素分析筛选男性早发冠心病的独立危险因素。冠状动脉造影病变程度由病变支数及病变Gensini总积分表示。危险因素包括高血压病、2型糖尿病、高脂血症、吸烟史、血红蛋白、总胆红素、血尿酸、血浆纤维蛋白原及缺血性心血管病家族史。结果　危险因素分析显示，男性早发冠心病组缺血性心血管病家族史的比例、血浆总胆固醇、血浆甘油三酯、血红蛋白水平、血浆纤维蛋白原水平及吸烟史显著高于晚发冠心病组。冠状动脉造影结果显示,男性早发冠心病患者在单支血管病变所占比例显著高于男性晚发冠心病组；而男性早发冠心病患者在回旋支和右冠状动脉血管病变所占比例及Gensini总积分中第四组所占比例显著低于男性晚发冠心病组。结论　缺血性心血管病家族史、吸烟、高甘油三酯血症、血浆纤维蛋白原、血红蛋白是男性早发冠心病患者的独立危险因素。男性早发患者冠脉病变较轻而且其单支冠状动脉病变多于男性晚发冠心病患者。预防冠心病应从尽早积极控制心血管病危险因素开始，改变不良生活方式，并加强对有血液高凝状态患者的重视。 【关键词】　男性早发冠心病；冠状动脉病变；危险因素 Study on the cardiovascular risk factors and coronary features of the male patients with premature coronary artery disease. Jun Chen, Zhigang Guo, wei Hu, et al.（Cardiology Department of Affiliated Nanang Hospital, Southern Medical University, Guangzhou, 510515） 【Abstract】　Objective　To explore the cardiovascular risk factors and clinical 简介：，男，在读硕士研究生，E-mail：chenj9@21 通讯作者：郭志刚，E-mail：guodoctor@feature of coronary lesions in the male patients with premature coronary artery disease (CAD). Methods　Coronary angiography was done in patients with coronary artery disease (CAD). Patients were divided into two groups by age. 145 male Patients with premature CAD (male＜55 ) were compared with the 303 old male patients (male≥55 Y) with mature CAD to illustrate the risk factors of premature CAD and the clinical features of coronary lesions. The extent and severity of angiographic CAD were diagnosed by the number of narrowed vessels and the CAD Gensini cumulative index. Cardiovascular risk factors included hypertension, smoking, type 2 diabetes mellitus, hemoglobin, total bilirubin, plasma lipid, plasma uric acid, plasma fibrinogen and family history of ischemic cardiovascular disease. Results The percentage of family history of ischemic cardiovascular disease, the history of smoking, the level of total cholesterol (TC), tr