摘要
目的分析非ST段抬高急性冠脉综合征(NSTE ACS)中代谢综合征患者的临床特征和住院期间预后。方法SUNDAY注册研究(TheStrategiesforUA NSTEMIandDelayofAngioplastYRegistry)回顾性登记了本院2000年1月至2002年12月三年间首次因不稳定性心绞痛(UA)或非ST段抬高心肌梗死(NSTEMI)在我院住院的患者1013例,比较合并代谢综合征患者与不伴代谢综合征的患者的临床特征和结果,并根据代谢综合征各组成数计算代谢综合征积分。结果有体重、身高及病史、生化检查记录完整的患者743例,其中符合我国代谢综合征定义的患者343人(46.2%),年龄较轻[(59.66±9.67)岁vs.(61.11±10.37)岁,P=0.052]。与不伴代谢综合征患者相比,合并代谢综合征患者除具有体重指数高、收缩压高、舒张压高、血糖高、血脂紊乱(P值均小于0.0001)的特点外,肌酐[(1.07±0.29)mg dlvs.(1.01±0.22)mg dl,P<0.0001]、白细胞总数[(7.05±1.81)Lvs.(6.75±1.98)L,P=0.039]均高于非代谢综合征的NSTE ACS患者。合并代谢综合征的患者的冠脉病变严重的比例较高,三支加左主干病变的比例明显高于不伴代谢综合征的患者(46.6%vs.32%,P<0.0001),住院天数明显延长(P=0.015),住院期间的费用明显增高(P=0.004)。应用Logistic分析发现心性事件和代谢综合征积分明显相关(P=0.017)并随代谢综合征积分的增加,患者有年轻化的趋势(P=0.03),代谢综合征的各组成成分也均有明显加重的趋势(P>0.05),而且严重冠脉病变(左主干+三支病变)的比例也明显增高(P=0.006),各组间不良心性事件的比例,差异也有显著性(P=0.039)。结论在NSTE ACS患者中,合并代谢综合征的比例较高,并有年轻化的特点。不良心性事件和代谢综合征积分明显正相关,即合并代谢综合征的成分越多,肥胖、糖尿病、高血压和血脂紊乱的严重程度越明显,冠脉病变越严重,不良心性事件的比例也越高。
Objective To elucidate the clinical characteristics and prognosis of non-ST segment elevation acute coronary syndrome （NSTE-ACS） patients with metabolic syndrome. Methods SUNDAY （The Strategies for UA/NSTEMI and Delay of AngioplastY Registry） study was a retrospective registry of 1013 patients with unstable angina or NSTEMI from Jan 2000 through Dec 2002. In this analysis , we compared the clinical features and prognosis with patients with or without metabolic syndrome and studied the relation between the number of markem-the MS score and prognosis. Results There were 743 patients with complete data and 343 patients （46.2%） satisfied the ,definition of Chinese metabolic syndrome . The latter were younger [ （59.66±9.67） age vs. （61.11 ± 10.37） age, P =0.052], with higher BMI , SBP, DBP, blood glucose and disordered blood-lipid （ P〈0.01, respectively）, with higher creatinine [ （1.07 ：t： 0.29） mg/dl vs. （1.01 ± 0.22） mg/dl, P〈0.0001] and leukocyte count [ （7.05 ± 1.81） /L vs. （6.75 ± 1.98） /L, P = 0.039） than patients without metabolic syndrome. The patients with metabolic syndrome had more severe coronary angiographic alterations （left main artery and triveszel） （46.6% vs. 32%, P〈0.01）, with more days of hospitalization （ P=0.015）, with more cost of hospitalization （ P= 0.004）. Applying of logistic analysis, we find it was visible related about cardiac events and metabolic syndrome score （ P=0.017）. And the more metabolic syndrome score , the younger of the patients was （P = 0.03）, the more severe of the ingredient of metabolize syndrome （ P〉0.05） and coronary angiographic alterations （left main artery and trivessel） （ P = 0.006）. Conclusion There were prevenlence in NSTE-ACS patients with metabolize syndrome and the later were younger . As the MS score increased so did obesity, dyslipidemia , blood pressure, fasting glucose. Similarly, an increasing MS score was significantly related to more severe coronary angiographic alterations and cardiac events.
出处
《中华急诊医学杂志》
CAS
CSCD
2006年第6期529-532,共4页
Chinese Journal of Emergency Medicine
