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目的 观察年轻人中冠心病危险因素的分布及聚集状况 ,为早期年轻人防治冠心病提供依据。方法 选择年轻冠心病患者 (经冠状动脉造影证实 ,年龄≤ 40岁 ) 1 78例作为疾病组 ,并以年龄匹配的冠状动脉造影正常的年轻人 70例作为对照组 ,分析了传统危险因素 (高血压、高血糖、高血脂、肥胖、吸烟史、家族史 )和新危险因素同型半胱氨酸 (HCY)、脂蛋白 (a)、小而密低密度脂蛋白、C反应蛋白 (CRP)在两组间的变化特点及聚集情况。结果 (1 )在传统的危险因素中 ,疾病组的甘油三酯(TG)和胆固醇 (TC)水平、吸烟和家族史的比率明显高于对照组 (P <0 0 5) ;在新的危险因素中 ,疾病组的血浆HCY(2 1 66± 1 8 2 2 ) μmol L和CRP(5 78± 6 90 )mg L比对照组的血浆HCY(1 4 94± 8 97)μmol L和CRP(2 87± 2 0 0 )mg L明显增高 (P <0 0 1 ) ,其他危险因素在两组间比较差异无显著性。(2 )疾病组与对照组比较 ,有危险因素者明显增多 (P <0 0 5) ,2种以上新危险因素聚集增加 ,3种新危险因素聚集比较差异有显著性 (P <0 0 5) ,传统危险因素聚集性比较差异无显著性。 (3)logistic回归显示吸烟 (OR值为 2 4,95 %CI:1 31 5～ 4 2 75)、TG(OR值为 1 8,95 %CI:1 2 1 5～ 2 541 )、HCY(OR值为 1 9,95 %CI:1 0 60
Objective To observe the distribution and aggregation of risk factors of coronary heart disease in young people and provide basis for prevention and treatment of coronary heart disease in young people in early stage. Methods One hundred and seventy-eight young patients with coronary artery disease (≤40 years of age) confirmed by coronary angiography were selected as the disease group and 70 age-matched young patients with normal coronary arteries as control group. The risk factors of traditional coronary artery disease Blood pressure, hyperglycemia, hyperlipidemia, obesity, smoking history and family history) and new risk factors of homocysteine (HCY), lipoprotein (a), small and dense low density lipoprotein and C-reactive protein Changes between the two groups and the characteristics of the situation. Results (1) Among the traditional risk factors, the prevalence of triglyceride (TG) and cholesterol (TC), smoking and family history in the disease group was significantly higher than that in the control group (P <0.05) The plasma levels of HCY (21 66 ± 1 8 2 2) μmol L and CRP (5 78 ± 6 90) mg L in the disease group were significantly higher than those in the control group for HCY (1494 ± 8 97) μmol L and CRP ( 2 87 ± 2 0 0) mg L was significantly higher (P 0 01), other risk factors in the two groups showed no significant difference. (2) Compared with the control group, the risk factors were significantly increased in the disease group (P <0.05), the aggregation of two or more new risk factors increased, and the aggregation of the three new risk factors was significant (P <0.05 ), There was no significant difference in the aggregation of traditional risk factors. (3) Logistic regression showed that smoking (OR 24 45% CI 1 31 5 -4 42 75), TG (OR 18 8 95% CI 1 12 15-2 541), HCY ( The OR value was 19,95% CI: 1060