老年冠心病病变程度与血糖及颈动脉斑块的关系分析

Relationship of the severity of coronary heart disease with blood glucose and carotid plaque in the elderly

摘要:

目的 探讨老年冠心病(CHD)病变程度与血糖及颈动脉斑块的关系。方法 以我院2015年12月～2018年11月268例疑似CHD且无糖尿病患者为研究对象,根据患者冠状动脉造影结果分为CHD组(170例)和非CHD组(98例)；另根据Gensini 评分将CHD分为轻度病变组(53例)、中度病变组(72例)和重度病变组(45例)；分析CHD病变程度与其空腹血糖(FPG)及颈动脉斑块的关系。采用SPSS 20.0软件进行统计分析。计量资料以均数±标准差([AKx-D]±s)表示,组间比较采用t检验或方差分析；计数资料以例数(百分率)表示,组间比较采用χ²检验。CHD发病危险因素采用logistic回归分析,CHD患者病变严重程度与血糖及颈动脉斑块相关性采用Pearson相关分析。结果 CHD组FBG水平[(6.41±2.46)mmol/L]、斑块数目[(1.86±1.12)个]、颈动脉硬化等级积分[(2.16±1.32)分]、Crouse积分[(1.92±1.63)分]均高于非CHD组[(5.06±1.21)mmol/L,(0.53±0.61)个,(0.38±0.55)分,(0.66±0.57)分；P<0.05]；重度病变组FPG[(6.82±1.67)mmol/L]水平、斑块数目[(2.93±1.24)个]、颈动脉硬化等级积分[(3.57±1.46)分]、Crouse积分[(3.87±2.24)分]明显高于中度病变组[(6.15±1.58)mmol/L,(1.64±1.72)个,(1.82±0.64)分,(2.13±0.85)分]与轻度病变组[(5.67±1.34)mmol/L, (0.67±0.69)个,(0.73±0.51)分,(0.96±0.62)分],且中度病变组明显高于轻度病变组(P<0.05)；logistic回归分析显示FPG水平、颈动脉硬化等级积分、Crouse积分是CHD发生的危险因素,且FPG水平、颈动脉硬化等级积分、Crouse积分与冠心病Gensini 评分均呈正相关。结论 老年CHD患者FPG水平、斑块数目、颈动脉硬化等级积分、Crouse积分均高于非CHD患者；FPG水平、颈动脉硬化等级积分、Crouse积分是CHD发病的独立危险因素,与Gensini 评分均呈正相关,在CHD病变的预测及病情评估中具有重要作用。

Abstract:

Objective To investigate the relationship of the severity of coronary heart disease (CHD) with blood glucose and carotid plaque. Methods From December 2015 to November 2018,8 non-diabetic patients with suspected CHD admitted to our hospital were selected and divided into CHD group (n=170) and non-CHD group (n=98) according to the results of coronary angiography. According to the Gensini score, the CHD patients were divided into mild group (n=53), moderate group (n=72) and severe group (n=45). An analysis was made of the relationship between the severity of coronary heart disease and fasting blood glucose (FPG) and carotid plaque. Statistical analysis was performed using SPSS statistics 20.0. Measurement data were expressed as mean±standard deviation ([AKx-D]±s), and t-test or analysis of variance was used for comparison between groups. Numeration data were expressed as number of cases (%). Inter-group comparison was performed using χ² test. Logistic regression analysis was used to identify risk factors for CHD, and Pearson correlation analysis was performed for relationship of the severity of CHD with blood glucose and carotid plaque in patients. Results The FBG level [(6.41±2.46)mmol/L], the number of plaques (1.86±1.12), the carotid sclerosis level score (2.16±1.32), and the Crouse score (1.92±1.63) in the CHD group were significantly higher than those in the non-CHD group [(5.06±1.21)mmol/L, 0.53±0.61,0.38±0.55,0.66±0.57; P<0.05]. The FPG level [(6.82±1.67)mmol/L], number of plaques (2.93±1.24), carotid sclerosis grade (3.57±1.46) and Crouse score (3.87±2.24) in severe CHD group were significantly higher than those in the moderate [(6.15±1.58)mmol/L, 1.64±1.72,1.82±0.64,2.13±0.85] and mild CHD group [(5.67±1.34)mmol/L, 0.67±0.69,0.73±0.51,0.96±0.62], and the moderate CHD group was significantly higher than the mild CHD group (P<0.05). Regression analysis showed that FPG level, carotid atherosclerosis grading score, Crouse score were risk factors for CHD, and that Gensini scores of CHD were positively correlated with FPG level, carotid atherosclerosis score, and Crouse score. Conclusion The FPG level, plaque number, carotid atherosclerosis score and Crouse score in elderly patients with CHD are significantly higher than in those with suspected CHD. FPG level, carotid atherosclerosis score and Crouse score are independent risk factors for CHD, having a positive correlation with CHD Gensini score and playing an important role in the prediction and assessment of CHD.