Chen Qingwei, Liu Ying, Yin Ying, Huang Wei, Li Guiqiong, Ke Dazhi
The Second Hospital of Chongqing Medical University, Department of Geriatrics, No. 74 Lin Jiang Road, Yuzhong District, 400010 Chongqing City, People's Republic of China.
Arch Gerontol Geriatr. 2008 Jan-Feb;46(1):107-15. doi: 10.1016/j.archger.2007.03.002. Epub 2007 May 7.
Our study aimed at investigating the relationship between metabolic syndrome (MS) and coronary heart disease (CHD) in aged patients, including 125 patients (age> or =60 years). Of them 78 cases belonged to the CHD group, which were subdivided into the CHD-MS group (38 cases) and the simple CHD group (40 cases); the other 47 patients without CHD belonged to the non-CHD group, which were subdivided again into the MS group (11 cases) and the control group (36 cases). Body mass index (BMI), blood lipids, blood uric acid, plasma fibrinogen, blood glucose and blood pressure of every patient were detected. The anatomy of coronary vessels was analyzed by selective coronary angiography to evaluate the relationship between MS and CHD. We found that the prevalence of MS in CHD group was significantly higher as compared to the groups not suffering from CHD (p<0.01). The CHD-MS group showed a higher prevalence of multivessel disease (p<0.05), unstable lesions (p<0.05) and needed more revascularization procedures (p<0.05) than the simple CHD group. The prevalence of CHD and the number of blocked coronary vessels were directly correlated with MS by Spearman correlation analysis (r=0.225, p<0.05; r=0.361, p<0.01). Logistic regression analysis demonstrated that both the risk of having future CHD and the number of blocked coronary vessels were directly correlated with MS (p<0.01; p<0.01), suggesting that MS can predict the prevalence and extent of future CHD in the elderly.
我们的研究旨在调查老年患者代谢综合征(MS)与冠心病(CHD)之间的关系,研究对象包括125例患者(年龄≥60岁)。其中78例属于冠心病组,该组又细分为冠心病合并代谢综合征组(38例)和单纯冠心病组(40例);另外47例无冠心病的患者属于非冠心病组,该组再细分为代谢综合征组(11例)和对照组(36例)。检测每位患者的体重指数(BMI)、血脂、血尿酸、血浆纤维蛋白原、血糖和血压。通过选择性冠状动脉造影分析冠状动脉血管解剖结构,以评估MS与CHD之间的关系。我们发现,与未患冠心病的组相比,冠心病组中MS的患病率显著更高(p<0.01)。与单纯冠心病组相比,冠心病合并代谢综合征组多支血管病变的患病率更高(p<0.05)、不稳定病变的患病率更高(p<0.05),且需要更多的血运重建手术(p<0.05)。通过Spearman相关性分析,冠心病的患病率和冠状动脉阻塞血管的数量与MS直接相关(r=0.225,p<0.05;r=0.361,p<0.01)。Logistic回归分析表明,未来患冠心病的风险和冠状动脉阻塞血管的数量均与MS直接相关(p<0.01;p<0.01),这表明MS可以预测老年人未来冠心病的患病率和严重程度。