摘要
目的分析深圳市宝安区早发冠心病(CHD)患者的关联环境危险因素,寻找降低早发CHD发病率的主要干预措施。方法收集深圳市宝安区人民医院339例CHD患者的临床资料,依据发病年龄分成早发CHD组(172例)和晚发CHD组(167例),以患者合并高血压病、合并糖尿病、吸烟史、酗酒史、总胆固醇(TC)升高、甘油三酯(TG)升高、低密度脂蛋白胆固醇(LDL-C)升高、高密度脂蛋白胆固醇(HDL-C)降低、C反应蛋白(CRP)升高、尿酸(UA)升高、纤维蛋白原(Fib)升高等为CHD的环境危险因素,通过χ2检验和Logistic回归法对两组患者的危险因素进行分析。结果早发CHD组的高TG百分率和低HDL-C百分率显著高于晚发CHD组(分别χ2=12.011,P=0.001;χ2=11.208,P=0.001),早发CHD组的男性比率和吸烟率也高于晚发CHD组(分别χ2=4.849,P=0.028;χ2=5.728,P=0.017),而早发CHD组合并高血压病患病率低于晚发CHD组(χ2=7.654,P=0.006);经多元Logistic回归校正协同因素后,血清TG升高和HDL-C降低是与早发CHD关联的危险因素(分别χ2=6.607,P=0.010;χ2=5.450,P=0.020)。合并高血压病则是与晚发CHD关联的危险因素(χ2=6.702,P=0.010)。结论在干预早发CHD措施中,以降低LDL-C为首要目标的降脂治疗应兼顾降低TG,吸烟带来的危险性也不容忽视。
Objective To analyze environmental risk factors of early - onset coronary heart disease in Baoan District, Shenzhen City, so as to explore intervention measures to decrease its incidence. Methods Totally 339 patients with coronary heart dis- ease from the People＇s Hospital of Baoan District, Shenzhen were included in the study and grouped into early - onset coronary heart disease group （172 eases） and late- onset coronary heart disease group （167 case.s） according to age at onset recorded in their clinical data. Having hypertension, diabetes, smoking, alcohol abuse, high total cholesterol （TC）, high triglycerides （TG）, high low density lipoprotein cholesterol （LDL）, low high density lipoprotein cholesterol （HI）L）, high C- reactive protein （CRP）, high uric acid （UA）, and high fibrinogen （Fib） as potential environmental risk factors, Chi - square test and logistic re- gression analysis were used to explore risk factors of early - onset coronary heart disease and late - onset coronary heart disease. Results The percentages of high TG and low HDL were significantly higher in the early - onset coronary heart disease group than those in the late-onset coronary heart disease group （x^2 = 12. 011, P = 0. 001;x^2 = 11. 208, P = 0. 001）. So were the men proportion and smoking rate （ x^2 = 4. 849, P = 0. 028 ; x^2 = 5. 728, P = 0. 017）. However, the incidence of hypertension was significantly lower in the early - onset coronary heart disease group than that in the late- onset coronary heart disease group （ x^2 = 7. 654, P = 0. 006）. Logistic regression analysis indicated that after collaborative factors were corrected, high TG and low HDL were the environmental risk factors for early - onset coronary heart disease （ x^2 = 6. 607, P = 0. 010; x^2 = 5. 450, P = 0. 020） and complication with hypertension was a risk factor for late - onset coronary heart disease （ x^2 = 6. 702, P = 0. 010）. Conclusions In the prevention of early - onset coronary heart disease, the lipid lowering therapy with lowering low density li- poprotein cholesterol as its primary goal should include lowering triglyeeride level. And risk from smoking can not be ignored.
出处
《实用预防医学》
CAS
2015年第4期424-427,共4页
Practical Preventive Medicine
基金
深圳市知识创新计划资助项目(项目编号:JCYJ20140414154847277)
关键词
早发冠心病
环境危险因素
甘油三酯
低密度脂蛋白胆固醇
高密度脂蛋白胆固醇
Early- onset coronary heart disease
Environmental risk factor
Triglycerides
low density lipoprotein cholesterol
High density lipoprotein cholesterol
