血尿酸、三酰甘油及高密度脂蛋白对冠心病及其严重程度的联合风险评估被引量：4

Combined risk assessment of serum uric acid,triglyceride and high density lipoprotein cholesterol for coronary heart disease and its severity

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摘要目的评估血尿酸、三酰甘油及高密度脂蛋白对冠心病及其严重程度的联合风险,为冠心病的预防和临床诊疗提供参考依据。方法 2013年1月至2015年3月在复旦大学附属闵行医院收集研究对象1 188例,根据冠状动脉造影结果判定是否患病及其严重程度,按照血尿酸、三酰甘油及高密度脂蛋白中位数将研究对象分为高风险组和低风险组,采用χ2检验分析血尿酸、三酰甘油及高密度脂蛋白对冠心病及其严重程度的单独及联合风险,采用线性估计回归模型评估风险趋势。结果当两两风险因素联合存在时,冠心病及其轻、中、重度病变分布于高风险组的比例明显高于在低风险组中的分布;当3种风险因素联合存在时,冠心病及其轻、中、重度病变分布于高风险组的比例分别高达95.9%、96.4%、92.9%和98.0%。各因素对男性冠心病的联合风险呈现出大于女性的趋势;3种因素对男性冠心病轻度病变和女性冠心病重度病变的联合风险最为明显。在50岁以下人群中3种风险因素对冠心病及其轻、中和重度病变的联合风险明显大于50岁以上人群。结论血尿酸、三酰甘油及高密度脂蛋白对冠心病及其严重程度的两两联合风险及三者联合风险明显大于单风险因素的效应,联合风险在男性人群和50岁以下人群中的效应更为明显。 Objective To assess the combined risk of serum uric acid,triglyceride and high density lipoprotein cholesterol in coronary heart disease（CHD）and its severity to provide the reference basis for prevention,diagnosis and treatment of CHD.Methods A total of 1188 research subjects were collected in the Affiliated Minhang Hospital of Fudan University from Jan.2013 to Mar.2015.The research subjects were judged whether suffering from CHD and its severity according to the results of coronary angiography results and divided into the high-risk group and low-risk group according to the medians of SUA,TG and HDL.The single risk and combined risk of SUA,TG and HDL for CHD and its severity were analyzed by adopting the Chi-square test.The risk trend was evaluated by adopting the linear estimation regression model.Results In the pairsise risk factors combined existence,the proportion of CHD and its mild-,moderate-and severe-lesions distribution in the high-risk group was larger than that in the single risk group;in 3-factor combined existence,the proportions of CHD and mild-,moderate-and severe-lesions distribution in the highrisk group reached up to 95.9%,96.4%,92.9% and 98.0% respectively.The combined risks of various factors on male CHD showed the trend more than female CHD;the combined risk of 3factors on male CHD mild lesion and female CHD severe lesion was most significant.The combined risk of 3factors on CHD and its mild,moderate and severe lesions in the population under 50 years old was greater than that in the population more than 50 years old.Conclusion The pairwise combined risk and 3-factor combined risk of SUA,TG and HDL are significantly greater than the that of single risk factor and the combined risk has obvious effect in male population and population under 50 years old.