影响冠心病患者冠状动脉病变支数的多因素分析

Multivariate Analysis of Coronary Artery Lesions in Patients with Coronary Heart Disease

摘要: 目的：探究影响冠心病患者冠状动脉病变支数的独立危险因素，为冠心病的预防和治疗提供理论指导。方法：选取在2016年5月1日至2018年2月28日期间于青岛大学附属医院住院接受冠状动脉介入治疗的528例患者进行研究，分为单支病变组(n = 182)、两支病变组(n = 232)、多支病变组(n = 114)，应用有序Logistic回归分析方法对年龄、体重指数、吸烟史、高血压病史、糖尿病病史及血脂异常史、慢性肾功能不全、脑卒中等冠心病相关因素进行分析，探究影响冠状动脉病变支数的独立危险因素。结果：1) 两支病变、多支病变患者年龄、糖尿病病史及血脂异常史比例均高于单支病变者，差异有统计学意义(P < 0.05)；多支病变患者吸烟史及高血压病史比例均高于单支病变者，差异有统计学意义(P < 0.05)；不同冠脉病变支数其余各指标比较，差异无统计学意义(P > 0.05)。2) 患者冠状动脉病变支数的因素分析示两支病变、多支病变患者年龄、糖尿病病史及血脂异常史比例均高于单支病变者，差异有统计学意义(P < 0.05)；多支病变患者吸烟史及高血压病史比例均高于单支病变者，差异有统计学意义(P < 0.05)；不同冠状动脉病变支数其余各指标比较，差异无统计学意义(P > 0.05)，进行有序Logistic回归分析结果示年龄、吸烟史、糖尿病病史及血脂异常史与患者冠状动脉病变支数独立相关(P < 0.05)。结论：性别、吸烟、糖尿病史、血脂异常史是目前冠心病患者冠状动脉病变支数的主要影响因素，尤其是男性患者，严格控制血糖、血脂、戒烟在冠心病的预防和治疗中应该得到重视，加强控制高危因素，避免或减缓冠状动脉病变的进展势在必行。

Abstract: Objective: To explore the factors affecting the number of coronary artery lesions in patients with coronary heart disease (CHD), and to provide theoretical guidance for the prevention and treatment of CHD. Methods: 528 patients who received coronary artery interventional therapy in the Affiliated Hospital of Qingdao University from May 1, 2016 to February 28, 2018 were divided into single vessel lesion group (n = 182), two vessel lesion group (n = 232) and multiple vessel lesion group (n = 114). Age, body mass index, smoking history and hypertension were studied by ordered logistic regression method. The history of diabetes mellitus, dyslipidemia, chronic renal insufficiency, stroke and other related factors of coronary heart disease were analyzed to explore the independent risk factors affecting the number of coronary artery lesions. Results: 1) The proportion of age, history of diabetes mellitus and history of dyslipidemia in two-vessel lesions, multi-vessel lesions was higher than that in single-vessel lesions (P < 0.05); the proportion of smoking history and history of hypertension in patients with multi-vessel lesions was higher than that in patients with single-vessel lesions (P < 0.05). There was no significant difference in other indicators (P > 0.05). 2) Factor analysis of the number of coronary artery lesions showed that the proportion of two-vessel lesions, age of patients with multiple-vessel lesions, history of diabetes mellitus and history of dyslipidemia was higher than that of single-vessel lesions (P < 0.05); the proportion of smoking history and history of hypertension in patients with multiple-vessel lesions was higher than that in patients with single-vessel lesions, the difference was significant (P < 0.05). Meaning (P < 0.05); there was no significant difference in the number of coronary artery lesion branches among different indexes (P > 0.05). The results of ordered multivariate logistic regression analysis showed that age, smoking history, history of diabetes mellitus and history of dyslipidemia were independently correlated with the number of coronary artery lesion branches (P < 0.05). Conclusion: Gender, smoking, diabetes mellitus and dyslipidemia are the main factors affecting the number of coronary artery lesions in patients with coronary heart disease. Especially in male patients, strict control of blood sugar, blood lipid and smoking cessation should be paid attention to in the prevention and treatment of coronary heart disease, and high-risk factors should be strengthened to avoid or slow down coronary artery disease. The progress of lesions is imperative.