摘要
目的探讨50岁以上继发孔房间隔缺损(ASD)患者冠状动脉疾病(CAD)的发病特点。方法以2010年1月至2015年12月沈阳军区总医院收治的50岁以上继发孔ASD患者525例为研究对象。本研究患者均进行冠状动脉造影(SCA),观察有无CAD及其病变程度。以冠状动脉狭窄面积≥50%作为CAD诊断标准。结果本研究中,CAD患者68例(13.0%)。男性CAD发病率(19.1%)高于女性(10.3%)。随年龄增长,CAD发病率逐渐增加。ASD不合并高血压和糖尿病CAD发病率为7.7%,合并高血压、糖尿病及二者并存时CAD发病率分别为22.6%、31.2%、50.0%。高血压和糖尿病是CAD独立危险因素。结论 ASD患者术前应根据年龄、性别及其他危险因素确定是否应常规行SCA检查。对于男性,尤其是合并高血压和糖尿病患者,即使年龄<50岁,术前也应常规行SCA排除CAD,而女性如果不合并高血压和糖尿病,常规SCA可考虑延迟至55岁之后。
Objective To investigate the prevalence of coronary artery disease（ CAD） in patients aged elder than 50 years old with secondary atrial septal defect（ ASD）. Methods A retrospective study was performed on 525 patients aged elder than 50 years old with secondary ASD in the General Hospital of Shenyang Military Command from January 2010 to December 2015. All the patients were performed selective coronary angiography（ SCA）,the presence of CAD and the degree of stenosis were observed. Significant CAD was defined as the presence of more than 50% stenotic lesions during SCA. Results Among the patients,significant CAD was detected in68 patients（ 13. 0%）. Patients with CAD exhibited male preponderance（ 19. 1% versus 10. 3%,P 〈0. 01）. The prevalence of CAD increased with age. The prevalence of CAD was 7. 7% in patients with ASD without hypertension and diabetes,22. 6% with hypertension,31. 2% with diabetes and 50. 0% with both,respectively. Hypertension and diabetes were the independent risk factors for CAD.Conclusion Whether routine SCA be performed to detect CAD in patients with ASD referred for cardiac surgery or device closure depends on not only age but also gender and risk factors. Routine SCA is recommended in male combined with hypertension and diabetes even the age is younger than 50 years. However,it seems reasonable to delay the cut-off age to perform SCA to 55 years for female without hypertension and diabetes.
出处
《临床军医杂志》
CAS
2016年第9期930-933,共4页
Clinical Journal of Medical Officers
关键词
先天性心脏病
房间隔缺损
冠状动脉疾病
危险因素
Congenital heart disease
Atrial septal defect
Coronary artery disease
Risk factor
