论文部分内容阅读
目的:探讨重庆地区冠心病(Coronary heart disease,CHD)危险因素。方法:收集我院2008年10月-2011年4月行冠状动脉造影病例1 834例,其中确诊CHD 1 169例,排除CHD 665例。分析比较各组间各危险因素的百分比、水平和比率。采用多因素Logistic回归分析方法筛选CHD相关因素。结果:1.CHD组的男性、有CHD家族史、糖尿病、高血压病、吸烟、高尿酸血症及高纤维蛋白原血症等指标比例均明显高于非CHD组(均为P<0.01)。CHD组年龄、收缩压、脉压、高血压病程、白细胞计数、载脂蛋白B、血肌酐、尿素氮、血尿酸、血浆纤维蛋白原、空腹指血血糖、餐后2 h指血血糖等指标水平均明显高于非CHD组(均为P<0.01)。CHD组总胆固醇/高密度脂蛋白胆固醇,甘油三酯/高密度脂蛋白胆固醇,低密度脂蛋白胆固醇/高密度脂蛋白胆固醇,载脂蛋白B/载脂蛋白AI等指标比值均明显高于非CHD组(均为P<0.01)。CHD组高密度脂蛋白胆固醇和载脂蛋白AI水平均明显低于非CHD组(均为P<0.01)。两组间肥胖、舒张压、甘油三酯、总胆固醇、低密度脂蛋白胆固醇等指标差异无统计学意义(均为P>0.05)。2.多因素Logistic回归分析表明男性、CHD家族史、糖尿病、高血压、吸烟、高纤维蛋白原血症、年龄、白细胞计数、载脂蛋白B均与CHD呈显著正相关(β值分别为0.496、1.149、0.595、0.592、0.953、0.282、0.050、0.155、1.488,均为P<0.01),高密度脂蛋白胆固醇与CHD呈显著负相关(β值为-0.575,P<0.05)。结论:1.男性、CHD家族史、糖尿病、高血压、吸烟、高纤维蛋白原血症、年龄、白细胞计数、载脂蛋白B与本地区CHD呈正相关,高密度脂蛋白胆固醇与本地区CHD呈负相关。2.降低载脂蛋白B水平、升高高密度脂蛋白胆固醇水平,控制糖尿病及高血压和戒烟等措施可以降低本地区CHD发病率及改善CHD预后。
Objective: To explore the risk factors of coronary heart disease (CHD) in Chongqing. Methods: A total of 1 834 cases of coronary angiography were collected from October 2008 to April 2011 in our hospital, including 169 cases of CHD confirmed and 665 cases of CHD excluded. The percentages, levels and rates of each risk factor were analyzed and compared. Multivariate Logistic regression analysis was used to screen for CHD related factors. The CHD group had significantly higher family history of CHD, diabetes, hypertension, smoking, hyperuricemia and hyperfibrinogenemia than those without CHD (all P <0.01) . CHD group, age, systolic blood pressure, pulse pressure, duration of hypertension, leukocyte count, apolipoprotein B, serum creatinine, blood urea nitrogen, serum uric acid, plasma fibrinogen, fasting blood glucose, Levels were significantly higher than non-CHD group (both P <0.01). In CHD group, the ratio of total cholesterol / high density lipoprotein cholesterol, triglyceride / high density lipoprotein cholesterol, low density lipoprotein cholesterol / high density lipoprotein cholesterol, apolipoprotein B / apolipoprotein AI was significantly higher CHD group (all P <0.01). The levels of high density lipoprotein cholesterol and apolipoprotein AI in CHD group were significantly lower than those in non-CHD group (all P <0.01). Obesity, diastolic blood pressure, triglyceride, total cholesterol, low density lipoprotein cholesterol and other indicators had no significant difference between the two groups (all P> 0.05). Multivariate logistic regression analysis showed that there was a significant positive correlation between CHD, family history of CHD, family history of CHD, hypertension, smoking, high fibrinogen, age, white blood cell count and apolipoprotein B (β = 0.496 , 1.149,0.595,0.592,0.953,0.282,0.050,0.155,1.488, all P <0.01). There was a significant negative correlation between high density lipoprotein cholesterol and CHD (β value -0.575, P <0.05). Family history of CHD, family history of diabetes, hypertension, smoking, hyper fibrinogen, age, white blood cell count, apolipoprotein B were positively correlated with CHD in the region, and high-density lipoprotein cholesterol Negative correlation. 2. To reduce the level of apolipoprotein B, high-density lipoprotein cholesterol levels, control of diabetes and hypertension and smoking cessation and other measures can reduce the incidence of CHD in the region and improve the prognosis of CHD.