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目的探讨老年(≥60岁)疑诊冠心病患者的冠心病危险因素及其冠状动脉病变严重程度的相关因素。方法选择我中心首次行诊断性冠状动脉造影(CAG)的老年疑诊冠心病患者4 732例。根据CAG结果分为冠心病组(3 539例)和非冠心病组(1 193例)。冠状动脉病变程度特点用Gensini积分和主要血管受累支数进行评价。采用多元线性回归和logistic回归进行数据分析。结果 1多元线性回归分析表明Gensini积分与患者年龄、男性、高血压病、高脂血症、糖尿病、慢性肾脏病及空腹血糖水平呈独立正相关,与血清总胆红素呈独立负相关。2多元线性回归分析表明病变支数与患者年龄、吸烟、男性、高血压病、高脂血症、糖尿病、慢性肾脏病、脑血管病及空腹血糖水平呈独立正相关,与血清总胆红素呈独立负相关。3二分类多因素Logistic分析显示,糖尿病是冠状动脉造影诊断冠心病最显著的独立相关危险因素(OR=2.591,95%CI:1.942-3.458,P<0.01),其他危险因素依次为男性、高血压病、吸烟、慢性肾脏病、高脂血症和年龄,总胆红素为其独立保护因素(OR=0.960,95%CI:0.941-0.979,P<0.01)。结论糖尿病是现阶段老年住院疑诊冠心病患者冠状动脉造影诊断冠心病最显著的独立相关危险因素,总胆红素水平为其独立相关保护因素。
Objective To investigate the risk factors of coronary heart disease (CHD) and the severity of coronary artery disease (CHD) in elderly patients (≥60 years old) with suspected coronary heart disease. Methods A total of 4732 elderly patients with suspected coronary artery disease underwent diagnostic coronary angiography (CAG) for the first time in our center. According to CAG results, they were divided into coronary heart disease group (3 539 cases) and non-coronary heart disease group (1 193 cases). The degree of coronary artery lesion was evaluated by Gensini score and the number of major vessel involvement. Data were analyzed using multivariate linear regression and logistic regression. Results 1 Multiple linear regression analysis showed that Gensini score was independently and positively correlated with age, male, hypertension, hyperlipidemia, diabetes, chronic kidney disease and fasting blood glucose level, and was negatively correlated with serum total bilirubin. 2 Multiple linear regression analysis showed that the number of lesions and patient age, smoking, men, hypertension, hyperlipidemia, diabetes, chronic kidney disease, cerebrovascular disease and fasting blood glucose levels were independently and positively correlated with serum total bilirubin Independent negative correlation. 3 Two-factor multivariate logistic analysis showed that diabetes was the most significant independent risk factor for coronary artery disease (OR = 2.591, 95% CI: 1.942-3.458, P <0.01). Other risk factors were male and high Blood pressure, smoking, chronic kidney disease, hyperlipidemia and age and total bilirubin were independent protective factors (OR = 0.960, 95% CI: 0.941-0.979, P <0.01). Conclusion Diabetes mellitus is the most significant independent risk factor for coronary artery disease diagnosed coronary artery disease in aged hospitalized patients with coronary heart disease. Total bilirubin level is independent protective factor.