摘要
目的 探讨冠状动脉痉挛变异型心绞痛发作与预后的影响因素。方法 回顾分析2000年1月—2017年12月山西医科大学第一医院心内科确诊为变异型心绞痛病人73例,依冠状动脉造影和心电图结果分为狭窄组与无狭窄组,并根据随访结果分为无不良事件组与不良事件组,收集相关资料,分析研究影响变异型心绞痛病人发作与预后的相关因素。结果 73例病人完成随访64例(87.7%),失访9例(12.3%);无冠状动脉狭窄49例,冠状动脉狭窄24例;未发生主要不良心血管事件(MACE)40例,发生MACE事件24例。男性、吸烟、饮酒、既往合并高脂血症者易发生血管痉挛;狭窄组年龄、吸烟比例、家族史比例、三酰甘油(TG)、总胆固醇(TC)、脂蛋白(a)[Lp(a)]高于无狭窄组(P<0.05);不良事件组年龄、男性比例、家族史比例、吸烟比例、冠状动脉狭窄比例、低密度脂蛋白胆固醇(LDL-C)、TC、Lp(a)高于无不良事件组(P<0.05);二元Logistic回归分析结果显示:吸烟、高胆固醇、长期服用硝酸酯类药物是冠状动脉痉挛变异型心绞痛病人发生心血管不良事件的独立危险因素。结论 年老、有吸烟史、有心血管家族史、高三酰甘油、高胆固醇、高Lp(a)者易出现冠状动脉狭窄;年老、男性、有心血管病家族史、吸烟、高胆固醇、高低密度脂蛋白胆固醇、冠状动脉管腔有狭窄者易发生不良事件。变异型心绞痛病人应积极改善生活方式(如戒烟、限酒等)、调脂,减少服用硝酸酯类药物,以减少不良事件发生,改善病人预后。
Objective To investigate the prevalence and prognosis influencing factors of coronary artery spasm variant angina pectoris. Methods A total of seventy-three patients suffering variant angina pectoris to receive treatment in the First Hospital of Shanxi Medical University from January 2000 to December 2017 were selected and divided into two groups according to the results of coronary angiograph and electrocardiogram:stenosis group and non-stenosis group.And we also divided all the selected patients into no MACE event group and MACE event group according to the follow-up results.Relevant clinical data was collected.To analysis the incidence and prognosis influencing factors of coronary artery spasm variant angina pectoris. Results In 73 cases,64(87.7%)cases completed the clinical follow-up and 9(12.3%)cases losses to follow-up.There were 49 cases of coronary artery stenosis,24 cases of non- coronary artery stenosis,24 cases with MACEs and 40 cases with non-MACEs.Young males,smoking,drinking,and previous hyperlipidemia were prone to vasospasm.Age,the proportion of smoking and family history of cardiovascular disease,triglycerides level,total cholesterol(TC) level and Lp (a) level in the stenosis group were higher than those in the non-stenosis group( P <0.05).Age,the proportion of male,family history of cardiovascular disease,coronary artery stenosis,LDL-C level,TC level,and Lp(a) level were higher in the MACE event group than those in the no MACE event group.The results of binary Logistic regression analysis showed that smoking,high cholesterol and long-term use of nitrates were independent risk factors for cardiovascular adverse events in patients with coronary spasm variant angina pectoris. Conclusion Patients with advanced age,smoking history,family history of cardiovascular disease,high triglycerides,cholesterol,and Lp(a)were prone to be suffered with coronary artery stenosis.Patients with advanced age,history of cardiovascular disease,smoking history,high cholesterol,high LDL-C,coronary artery stenosis,and male were prone to be suffered with MACEs.Patients with variant angina pectoris should actively improve their lifestyle (such as smoking cessation,alcohol restriction,etc.),regulate fat,reduce the use of nitrates in order to reduce the occurrence of adverse events and improve the prognosis of patients.
作者
靳春荣
彭黎
侯清濒
吴琼
白雪琦
范春雨
贾永平
JIN Chunrong;PENG Li;HOU Qingbin;WU Qiong;BAI Xueqi;FAN Chunyu;JIA Yongping(First Hospital of Shanxi Medical University,Taiyuan 030001,China)
出处
《中西医结合心脑血管病杂志》
2019年第13期1929-1933,共5页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
山西省卫生健康科研课题(No.2018035)
