摘要
目的研究克拉玛依地区45岁及以下冠心病患者的临床特点和遗传学特点。方法回顾性分析2017年10月至2018年10月在克拉玛依市中心医院心血管内科住院的95例冠心病患者的临床资料,依据疾病发生年龄分为A组(n=45,≤45岁,早发冠心病患者)与B组(n=50,>45岁,非早发冠心病患者),另选50名正常对照者作为C组。分析早发冠心病患者的相关临床危险因素、冠脉病变特点、预后情况。结果Logistic回归分析发现,家族史、血脂异常、工作及生活压力为导致早发冠心病的独立危险因素(OR>1,P<0.05);早发冠心病患者的高血压占比明显高于非早发冠心病患者;早发冠心病组患者通常以左前降支病变为主,而非早发组以左回旋支及右冠脉病变多见,差异有统计学意义(P<0.05);手术后,随访6个月内,早发冠心病患者的再次血运情况显著高于非早发冠心病患者,且心血管病死亡患者占比明显低于非早发冠心病患者,差异有统计学意义(P<0.05);两组患者全因死亡占比比较,差异无统计学意义;A组患者miRNA-21表达水平高于B组及C组,差异有统计学意义(P<0.05)。结论有家族史、高血压、血脂异常、肥胖、有工作及生活压力均为导致早发冠心病发生的危险因素,且miRNA-21表达水平与早发冠心病的发生密切相关,患者可采取健康的生活方式,控制血脂、血压等方式,降低早发冠心病的发生率,临床上可通过手术降低早发冠心病死亡率。
Objective To study the clinical characteristics and genetic characteristics of patients with coronary heart disease under 45 years old in Karamay area.Methods The clinical data of 95 patients with coronary heart disease admitted to the Department of Cardiology,Karamay Central Hospital from October 2017 to October 2018 were retrospectively analyzed.The patients were divided into group A(n=45,≤45 years old,patients with premature coronary heart disease)and group B(n=50,>45 years old,non premature coronary heart disease patients)according to the age of disease,and 50 normal controls were selected as group C.To analyze the clinical risk factors,coronary artery lesions and prognosis of patients with premature coronary heart disease.Results Logistic regression analysis showed that family history,dyslipidemia,work and life stress were independent risk factors for early-onset coronary heart disease(OR>1,P<0.05).The proportion of hypertension in patients with premature coronary heart disease was significant higher than non-early-onset coronary heart disease.Coronary artery disease in early-onset coronary heart disease:the early-onset coronary artery disease group is usually left anterior descending artery disease,while the non-early-onset group is more common in left circumflex artery and right coronary artery disease,the difference was statistically significant(P<0.05).After surgery,during the follow-up period of 6 months,the re-transmission of patients with premature coronary heart disease was significantly higher than that of patients with non-premature coronary heart disease,and the proportion of patients with cardiovascular disease died.Compared with patients with non-premature coronary heart disease,the difference was statistically significant(P<0.05).There was no significant difference in the proportion of all-cause mortality between the two groups.The expression level of miRNA-21 in group A was higher than that in group B and group C,and the difference was statistically significant(P<0.05).Conclusion Family history,hypertension,dyslipidemia,obesity,work and life stress are all related factors leading to the occurrence of premature coronary heart disease,and the expression level of miRNA-21 is closely related to the occurrence of early onset coronary heart disease.Patients can adopt healthy lifestyle,control of blood lipids,blood pressure and other means,thereby reducing the incidence of premature coronary heart disease,clinically can reduce the incidence of premature coronary heart disease death by surgery.
作者
李岩
封冲
郁洁
邵丹
刘晓红
Li Yan;Feng Chong;Yu Jie;Shao Dan;Liu Xiaohong(Department of Cardiology,Karamay City Center Hospital,Karamay,Xinjiang,834000,China)
出处
《当代医学》
2020年第33期70-73,共4页
Contemporary Medicine
关键词
冠心病
早发
肥胖
家族史
Coronary heart disease
Early onset
Obesity
Family history
