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目的研究老年冠心病的相关因素。方法选取溧阳市中医医院2013—2015年疑诊为冠心病并进行冠状动脉造影的90例患者,造影结果正常者为正常组15例,余下75例患者为病变组(依据冠状动脉病变分支分为单支病变组38例,双支病变组23例,三支病变组14例)。两组均采用超声颈动脉检查,检测颈动脉斑块发生情况及大内膜中层厚度,同时观察患者血糖(BS)、高密度脂蛋白胆固醇(HDL-C)、血清超敏C反应蛋白(CRP)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)等。结果病变组最大MT值高于正常组,各组患者间颈动脉最大MT值比较,差异有统计学意义(P<0.05);病变组斑块发生率高于正常组,差异有统计学意义(P<0.05)。病变组CRP高于正常组,病变各组间比较,差异有统计学意义(P<0.05);正常组LDL-C、TC、TG水平低于病变组,HDL-C高于病变组,差异有统计学意义(P<0.05);各病变组间LDL-C、TC、TG、HDL-C比较,差异无统计学意义(P>0.05);各组间BS比较,差异无统计学意义(P>0.05)。Logistic多元回归分析结果显示,BS、HDL-C、CRP、TG、MT为冠状动脉粥样硬化的危险因素(P<0.05)。结论冠状动脉粥样硬化与颈动脉粥样斑块存在明显相关性。
Objective To study the related factors of coronary heart disease in the elderly. Methods Ninety patients suspected to be coronary heart disease and coronary angiography were selected from Liyang Chinese Medicine Hospital from 2013 to 2015. The normal angiography results were 15 cases in normal group and 75 cases were in diseased group (according to the branches of coronary artery disease 38 cases of single-vessel disease, 23 cases of double-vessel disease, and 14 cases of three-vessel disease. The carotid plaques and the intima-media thickness were detected by ultrasonic carotid artery in both groups. The levels of blood glucose (BS), high density lipoprotein cholesterol (HDL-C), serum high-sensitivity C-reactive protein ), Triglyceride (TG), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC) and so on. Results The maximum MT value in the lesion group was higher than that in the normal group, and the maximum MT value of the carotid artery in each group was statistically significant (P <0.05). The incidence of plaque in the lesion group was higher than that in the normal group P <0.05). The CRP in the lesion group was higher than that in the normal group, and the difference was statistically significant (P <0.05). The levels of LDL-C, TC and TG in the normal group were lower than those in the lesion group, and the HDL- (P <0.05). There was no significant difference in LDL-C, TC, TG and HDL-C between different groups (P> 0.05). There was no significant difference in BS between groups > 0.05). Logistic multiple regression analysis showed that BS, HDL-C, CRP, TG and MT were the risk factors for coronary atherosclerosis (P <0.05). Conclusion Coronary atherosclerosis has obvious correlation with carotid artery plaque.