本文選題：早發(fā)冠心病 + 血脂水平�。� 參考：《華北理工大學(xué)》2017年碩士論文

【摘要】：目的調(diào)查分析早發(fā)冠心病(p CAD)患者的主要危險(xiǎn)因素、冠脈造影結(jié)果和遺傳因素特點(diǎn),并探討其與p CAD患者血脂水平變化的關(guān)系。方法1回顧性分析2015年1月至2016年1月住院行冠狀動(dòng)脈造影確診的CAD患者805例,完整記錄臨床資料,收集血液樣本,檢測(cè)血脂及其他生化指標(biāo);2根據(jù)年齡分為早發(fā)組(男性≤50歲,女性≤60歲)和晚發(fā)組(男性50歲,女性60歲),探討兩組間和不同CAD類型危險(xiǎn)因素的特點(diǎn)及血脂異常率的分布;3對(duì)p CAD及血脂異常的主要危險(xiǎn)因素進(jìn)行l(wèi)ogistic回歸分析;4運(yùn)用Taqman MGB探針定量PCR檢測(cè)p CAD中可疑FH患者的LDLR基因熱點(diǎn)突變,探討遺傳因素可能對(duì)p CAD患者血脂水平變化的影響。結(jié)果1本研究納入CAD患者805例,早發(fā)組486例,晚發(fā)組319例。比較兩組基本資料及血管病變情況:年齡(47 vs 55,P0.0001),吸煙(56.6%vs 49.1%,P0.0001),家族史(22.92%vs 15.97%,P=0.0173),BMI(26.52%vs 16.28%,P=0.0115);單支病變(36.12%vs 26.69%,P0.01),多支病變(63.88%vs73.31%,P0.01);2比較兩組間生化指標(biāo):TC(4.25 vs 4.10,P=0.0236)mmol/L;3兩組間的血脂異常率(79.41%vs 70.85%,P=0.0053),LDL-C異常率(25.72%vs 19.12%,P=0.0298);4比較三種不同類型CAD的血脂異常率:LDLC(25.86%vs 22.30%vs 37.70%,P=0.0404),TG(49.14%vs 51.01%vs 67.21%,P=0.0478),HDL-C(25.86%vs 36.15%vs 22.95%,P=0.0359);5 Logistic回歸分析p CAD的主要危險(xiǎn)因素:TC(OR=0.559,0.329~0.950 95%CI),LDL-C(OR=1.991,1.080~3.668 95%CI),TG(OR=1.219,1.029~1.445 95%CI),Hcy(OR=1.022,1.005~1.039 95%CI),吸煙(OR=0.289,0.202~0.411 95%CI);6Logistic回歸分析影響p CAD血脂異常的危險(xiǎn)因素:性別(OR=0.447,0.206~0.97195%CI),冠心病類型(OR=0.598,0.385~0.929 95%CI),Glu(OR=0.776,0.651~0.927 95%CI)。7發(fā)現(xiàn)可疑FH患者89例,其中存在3例W462X,3例A606T和1例D601Y突變。結(jié)論1 pCAD患者發(fā)病年齡較輕,且多存在吸煙、家族史和肥胖等危險(xiǎn)因素;p CAD患者以單支病變?yōu)橹?晚發(fā)CAD患者以多支病變?yōu)橹?2早發(fā)組的TC、LDL-C水平普遍高于晚發(fā)組。3 p CAD患者中以AMI類型最為多見,以non STEMI患者最易伴發(fā)血脂異常;4吸煙、血脂異常和高Hcy血癥是p CAD的主要危險(xiǎn)因素;而性別、CAD類型可能是影響血脂水平變化的關(guān)鍵因素;5 p CAD人群中約10%為FH患者。
[Abstract]:Objective to investigate and analyze the main risk factors, coronary angiography results and genetic factors in patients with premature coronary heart disease (pCAD), and to explore the relationship between the risk factors and the changes of blood lipid level in patients with premature coronary heart disease (pCAD). Methods 1 A total of 805 CAD patients diagnosed by coronary angiography from January 2015 to January 2016 were retrospectively analyzed. Clinical data were recorded and blood samples were collected. Serum lipids and other biochemical markers were measured and divided into early onset group (male 鈮，

本文編號(hào)：2081168