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目的探讨代谢综合征(metabolic syndrome,MS)患者冠状动脉病变特点及相关危险因素。方法纳入作冠脉造影的患者654例,所有患者均查体重指数、腹围、非同日血压、血脂、空腹及餐后2h血糖。冠状动脉的狭窄程度用造影图像处理系统测量,根据病变损害的程度评分。冠状动脉狭窄大于或等于50%诊断为冠心病(coronaryartery disease,CAD)425例,其中129例合并MS(冠心病合并MS组),296例不合并MS(对照组)。结果冠脉造影患者中冠心病合并MS的患病率为30.4%(129/425),与对照组相比较,甘油三酯(triglyeride,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)的差异有统计学意义(P<0.05)。冠心病合并MS组高血糖、高血压、肥胖患病率显著高于对照组;MS组的冠状动脉造影主要表现为3支血管病变或多支多节段血管病变,病变率分别为51.2%、30.9%,明显较不合并MS组的情况严重。偏相关分析排除其他易患因素,如年龄、吸烟量的影响后,仍示MS的严重情况与冠状动脉血管狭窄程度有显著的相关性。而且,无论是病情的严重程度,还是需要血运重建的患者数都显著高于不合并MS组。结论MS可作为冠状动脉狭窄严重程度的参考指标之一。全面干预MS的各个成分,对冠心病的防治具有重要临床意义。
Objective To investigate the characteristics of coronary lesions and related risk factors in patients with metabolic syndrome (MS). Methods 654 patients were enrolled in coronary angiography, all patients were checked body mass index, abdominal circumference, non-same day blood pressure, blood lipids, fasting and postprandial blood glucose 2h. Coronary stenosis was measured with a radiographic image processing system and scored according to the degree of lesion damage. Coronary artery stenosis was diagnosed as coronary artery disease (CAD) by more than or equal to 50%, of which 129 cases were combined with MS (coronary heart disease with MS group) and 296 without MS (control group). Results The prevalence of coronary heart disease complicated with MS in coronary angiography was 30.4% (129/425). Compared with the control group, triglyeride (TG), high density lipoprotein cholesterol (HDL) -C), the difference was statistically significant (P <0.05). The prevalence of hyperglycemia, hypertension and obesity was significantly higher in the patients with coronary heart disease complicated with MS than those in the control group. The coronary angiography in MS group mainly manifested as 3 vessel disease or multi-vessel multi-segmental vessel disease with the rates of 51.2% 30.9%, significantly worse than the non-merger MS group. Partial correlation analysis to exclude other risk factors, such as age, the impact of smoking, still shows the serious situation of MS and coronary stenosis have a significant correlation. Moreover, both the severity of the disease and the number of patients requiring revascularization were significantly higher than those without MS. Conclusion MS can be used as a reference index for the severity of coronary artery stenosis. Comprehensive intervention of the various components of MS, prevention and treatment of coronary heart disease has important clinical significance.