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目的探讨通过对冠心病的危险因素进行干预和控制对无症状性冠状动脉内膜病变发生的预防作用。方法对2004年1月至12月日本医科大学附属千叶北总病院收治的120例陈旧性心肌梗死和稳定型心绞痛患者的非罪犯血管应用冠状动脉血管内视镜技术进行观察,探讨黄色斑块、斑块破裂和(或)血栓形成等内膜病变与高血压、糖尿病、高低密度脂蛋白胆固醇(LDL-C)血症病人中血压、血糖和LDL-C等水平之间的关系。结果在120例患者155支非罪犯血管内,观察到内膜病变者80例(66.67%),非内膜病变者40例(33.33%),在内膜病变组中观察到单纯黄色斑块者30例(25.00%),复杂性斑块者50例(41.67%)。120例患者中合并高血压者69例(57.50%),合并高LDL-C血症患者79例(65.83%),合并2型糖尿病患者40例(33.33%)。血压<140/90mmHg(1mmHg=0.133kPa)者中观察到复杂性斑块者低于血压≥140/90mmHg者(P<0.05);2型糖尿病患者中血糖控制良好者内膜病变和斑块破裂的发生率均低于控制不良者(P<0.05);高LDL-C血症病人中LDL-C水平控制在2.60mmol/L以下者在各种内膜病变发生情况与≥2.60mmol/L者相比均有减少趋势,但差异无统计学意义(P>0.05)。结论积极有效治疗高血压、糖尿病和高LDL-C血症,使其控制在理想水平,可以有效地预防粥样斑块的破裂,从而预防急性冠状动脉综合征(ACS)的发生。
Objective To investigate the preventive effect of intervention and control on risk factors of coronary heart disease (CHD) by coronary heart disease. Methods One hundred and twenty cases of patients with chronic myocardial infarction and stable angina who were admitted to Chiba General Hospital affiliated to Nihon University of Medical Science from January to December 2004 were investigated by coronary angiography with endovascular coronary angioscopy. , Plaque rupture and / or thrombosis and other blood pressure, blood pressure, high blood pressure and LDL-C levels in patients with hypertension, diabetes, high-density lipoprotein cholesterol (LDL-C) Results In 155 vessels of 120 patients, 80 cases (66.67%) of endometrial lesions and 40 (33.33%) cases of non-endometrial lesions were observed. Only yellow patches were observed in the endometriosis group 30 cases (25.00%), complicated plaques in 50 cases (41.67%). Sixty-nine patients (57.50%) with hypertension in 120 patients, 79 patients (65.83%) with high LDL-C and 40 patients (33.33%) with type 2 diabetes mellitus. Patients with complex plaques below BP ≥140 / 90mmHg (P <0.05) were found to have blood pressure <140/90 mmHg (1 mmHg = 0.133 kPa); patients with type 2 diabetes who had good glycemic control had endometrial lesions and plaque rupture (P0.05) .The incidence of LDL-C in hyperlipidemic patients with LDL-C less than 2.60mmol / L was significantly higher than those in controls (≥2.60mmol / L Compared with the decreasing trend, but the difference was not statistically significant (P> 0.05). Conclusion The active and effective treatment of hypertension, diabetes mellitus and high LDL-C is controlled at an ideal level, which can effectively prevent the rupture of atherosclerotic plaque and prevent the occurrence of acute coronary syndrome (ACS).