摘要
目的以体质量指数(BMI)、腰围与身高的比值(RWH)、内脏脂肪(VAT)与皮下脂肪(SAT)比值为测量指标,衡量腹部脂肪分布对冠心病患者冠状动脉病变程度的影响。方法疑诊冠心病患者376例,均行冠状动脉造影检查,采用Judkins法评估冠状动脉病变程度,其中冠状动脉内径狭窄≥50%为冠状动脉狭窄(冠心病组),冠状动脉内径狭窄<50%为非冠状动脉狭窄(对照组),采用Gensini法对冠状动脉病变进行定量评估,记录患者身高、体质量、腰围、血脂、血压等数据,并计算BMI及RWH;患者均行上腹部CT检查,测量VAT、SAT;Pearson相关分析BMI、RWH、VAT/SAT及Gensini积分的相关性,二元Logistic回归分析BMI、RWH、VAT/SAT对发生冠心病的影响,逐步多重线性回归分析BMI、RWH、VAT/SAT对Gensini积分的影响。结果376例疑诊冠心病患者,依据冠状动脉造影确诊冠心病240例为冠心病组,其中单支病变108例,双支病变80例,三支病变52例,非冠心病136例为对照组;冠心病组收缩压、空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、BMI、RWH、VAT/SAT、Gensini积分均高于对照组,高密度脂蛋白胆固醇低于对照组(P<0.05);单支病变、双支病变、三支病变患者RWH、VAT/SAT及Gensini积分均逐渐增加,两两比较差异均有统计学意义(P<0.05),双支病变、三支病变患者BMI高于单支病变患者(P<0.05),双支病变与三支病变患者BMI比较差异无统计学意义(P>0.05);Pearson相关分析结果显示,Gensini积分与RWH(r=0.838, P=0.023)、VAT/SAT(r=0.892, P=0.001)均呈正相关,与BMI(r=0.651, P=0.328)无线性相关;二元Logistic回归分析结果显示BMI>26 kg/m^2(OR=1.75, 95%CI 1.53~2.36, P=0.043)、RWH>0.7(OR=2.81, 95%CI 1.39~5.67, P=0.015)、VAT/SAT>0.6(OR=4.85, 95%CI 2.86~8.92, P=0.008)是发生冠心病的危险因素;逐步多重线性回归分析显示,BMI对Gensini积分无明显影响,RWH、VAT/SAT是Gensini积分的影响因素,标准化回归系数分别为0.36
Objective The body mass index (BMI),waist to height ratio (RWH),visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were used to measure the effect of abdominal fat distribution on the degree of coronary artery disease in patients with coronary heart disease.Methods A total of 376 patients with suspected coronary heart disease underwent coronary angiography.The degree of coronary artery disease was evaluated by Judkins method.The coronary artery stenosis ≥50% was coronary artery stenosis (coronary heart disease group),and the coronary artery diameter stenosis was <50%.For non-coronary stenosis (control group),the Gensini method was used to quantitatively evaluate coronary lesions,and the patient's height,body mass,waist circumference,blood lipids,blood pressure and other data were recorded,and BMI and RWH were calculated.All patients underwent upper abdominal CT examination.Measurement of VAT,SAT;Pearson correlation analysis of BMI,RWH,VAT/SAT and Gensini score correlation,multivariate Logistic regression analysis of BMI,RWH,VAT/SAT on coronary heart disease,stepwise linear regression analysis of BMI,RWH,VAT/SAT's impact on Gensini points.Results Of 376 patients with suspected coronary heart disease,240 patients with coronary heart disease were diagnosed as coronary heart disease by coronary angiography,including 108 with single-vessel disease,80 with double-vessel disease,52 with three-vessel disease,and 136 with non-coronary heart disease.The systolic blood pressure,fasting blood glucose,total cholesterol,triglyceride,low-density lipoprotein cholesterol,BMI,RWH,VAT/SAT,and Gensini scores in the coronary heart disease group were higher than those in the control group,and high-density lipoprotein cholesterol was lower than the control group (P <0.05).RWH,VAT/SAT and Gensini scores of patients with single-vessel disease,double-vessel disease and three-vessel disease gradually increased,and the difference between the two groups was statistically significant (P<0.05).The BMI of double-vessel diseas
作者
张越
张晓辉
王磊
曹威
Zhang Yue;Zhang Xiaohui;Wang Lei;Cao Wei(Department of Cardiology,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处
《中国实用护理杂志》
2019年第8期566-571,共6页
Chinese Journal of Practical Nursing
基金
国家自然科学基金青年项目(81800362).
关键词
冠心病
冠状动脉
肥胖
严重程度
Coronary heart disease
Coronary artery
Obesity
Severity
