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目的分析代谢综合征(MS)及其成分对冠状动脉粥样硬化性病变进展的作用。方法行冠状动脉造影或冠状动脉CT血管造影检查,并在间隔≥6个月后复查冠状动脉情况的患者245例,根据是否为MS、冠状动脉病变进展、冠状动脉病变明显进展进行分组。比较组间临床资料及生化水平差异。并通过回归分析,分析MS及其成分对冠状动脉病变进展的作用。结果 MS组与非MS组对比,MS组Gensini进展率[2.8(0.0,11.9)vs.0(0.0,4.4),P=0.007],复查Gensini评分[9.8(5.0,23.8)vs.5.0(1.0,15.0),P=0.008],冠状动脉病变明显进展发生率(59.1%vs.45.2%,P=0.037)比非MS组的高。通过单因素回归分析,MS发病率与冠状动脉病变明显进展正相关(OR=1.75,95%CI:1.03~2.97,P=0.038)。通过多因素回归分析,是否有高血压病与冠状动脉病变进展(OR=2.60,95%CI:1.44~4.70,P=0.002)、明显进展相关(OR=3.36,95%CI:1.82~6.22,P<0.001)。结论 MS组的冠状动脉病变进展速度更快。MS成分中,高血压病可能是导致冠状动脉病变进展的主要危险因素。
Objective To analyze the effect of metabolic syndrome (MS) and its components on the progression of coronary atherosclerotic lesions. Methods 245 patients underwent coronary angiography or coronary CT angiography and coronary arteries were reviewed after ≥6 months. The patients were divided into groups based on whether they were MS, the progression of coronary lesions and the progression of coronary lesions. The differences of clinical data and biochemical levels between the two groups were compared. And through regression analysis, analysis of MS and its components on the progression of coronary artery disease. Results The progression of Gensini in MS group was significantly higher than that in non-MS group [2.8 (0.0, 11.9) vs.0 (0.0, 4.4), P = 0.007] , 15.0), P = 0.008]. The incidence of coronary artery disease (59.1% vs.45.2%, P = 0.037) was significantly higher than that of non-MS patients. By univariate regression analysis, the incidence of MS was positively correlated with the significant progression of coronary artery disease (OR = 1.75, 95% CI: 1.03-2.97, P = 0.038). Multivariate regression analysis showed that there was a significant correlation between hypertension and progression of coronary artery disease (OR = 2.60,95% CI: 1.44-4.70, P = 0.002) (OR = 3.36,95% CI: 1.82-6.22, P <0.001). Conclusion The coronary lesions in MS group progressed faster. Among the components of MS, hypertension may be the main risk factor leading to the progression of coronary artery disease.