早发冠心病的影响因素及病变血管特点的分析

Analysis of Influencing Factors of Premature Coronary Heart Disease and Characteristics of Diseased Vessels

摘要: 目的：探讨早发冠心病影响因素及病变血管特点。方法：回顾性分析2023年6月至2024年3月在包头医学院第一附属医院心内二科行冠状动脉造影检查并确诊为冠状动脉粥样硬化性心脏病的患者229例，其中早发冠心病患者81例，晚发冠心病患者148例，收集并分析其年龄、性别、吸烟史、饮酒史、高血压病史、糖尿病病史、TG、TC、LDL-C、HDL-C、脂蛋白a、UA、Cr、胱抑素C、BNP、LVEF、病变血管支数、病变血管部位等临床资料，从而得出早发冠心病影响因素及病变血管特点。结果：1) 与晚发冠心病组相比，早发冠心病组吸烟史比例(58.0% VS 39.9%)、饮酒史比例(28.4% VS 14.1%)显著升高(均P < 0.05)；早发冠心病组TG、TC、LDL-C水平显著升高，但胱抑素C、D二聚体、BNP水平显著降低(均P < 0.05)。2) 与晚发冠心病组相比，早发冠心病组冠脉单支病变比例(46.9% VS 30.4%)显著升高，但左回旋支病变比例(40.7% VS 60.1%)显著下降(均P < 0.05)；而治疗方式中早发冠心病组选择药物 + PCI比例(82.7% VS 71.6%)显著升高，但选择药物 + CABG (3.7% VS 14.9%)的比例显著下降(均P < 0.05)。结论：早发冠心病患者吸烟史、饮酒史、冠脉单支病变比例高于晚发冠心病患者，早发冠心病患者血脂TG、TC、LDL-C水平高于晚发冠心病患者，早发冠心病治疗方面早发冠心病患者采用药物 + PCI比例高于晚发冠心病患者，而采用药物 + CABG比例低于晚发冠心病患者。

Abstract: Objective: To investigate the influencing factors of premature coronary heart disease and the characteristics of diseased vessels. Methods: A retrospective analysis was performed on 229 patients diagnosed with coronary atherosclerotic heart disease who underwent coronary angiography in the Second Department of Cardiology, the First Affiliated Hospital of Baotou Medical College from June 2023 to March 2024, including 81 patients with premature coronary heart disease and 148 patients with late coronary heart disease. Clinical data such as age, sex, smoking history, drinking history, hypertension history, diabetes history, TG, TC, LDL-C, HDL-C, lipoprotein a, UA, Cr, cystatin C, BNP, LVEF, number of diseased vessels and location of diseased vessels were collected and analyzed, so as to obtain the influencing factors of premature coronary heart disease and the characteristics of diseased vessels. Results: 1) Compared with the late-onset CHD group, the proportion of smoking history (58.0% vs 39.9%) and drinking history (28.4% vs 14.1%) in premature CHD group were significantly increased (both P < 0.05). The levels of TG, TC and LDL-C in premature CHD group were significantly increased, but the levels of cystatin C, D dimer and BNP were significantly decreased (all P < 0.05). 2) Compared with the late coronary artery disease group, the proportion of single coronary artery disease (46.9% vs 30.4%) in the premature coronary artery disease group was significantly increased, but the proportion of left circumflex artery disease (40.7% vs 60.1%) was significantly decreased (all P < 0.05). The proportion of drug + PCI (82.7% vs 71.6%) was significantly increased in the premature CHD group, but the proportion of drug + CABG (3.7% vs 14.9%) was significantly decreased (all P < 0.05). Conclusion: Smoking history, drinking history and proportion of coronary artery disease in patients with premature coronary heart disease were higher than those with late-onset coronary heart disease; levels of lipid TG, TC and LDL-C in patients with premature coronary heart disease were higher than those with late-onset coronary heart disease; and the proportion of drug + PCI in patients with premature coronary heart disease was higher than those with late-onset coronary heart disease. The proportion of drug + CABG was lower than that of patients with late coronary heart disease.