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目的通过招募美国马里兰州巴尔第摩市年龄25~54岁的黑人青年有(无)HIV感染和(或)应用可卡因者使用酶抑制剂(PI)以及长期应用可卡因是否出现冠状动脉狭窄进行研究。方法对在美国马里兰州巴尔第摩市招募的既往无心血管症状和传统心血管危险因素的109名年龄在25~54岁,有(无)HIV感染和(或)应用可卡因黑人青年,抽血检测血脂、血糖并应用64排多层CT对心脏及冠状动脉进行扫描,并采用Logistic回归模型对可能引起冠状动脉狭窄的因素进行分析。结果109名被调查者的年龄为25~54岁,39名(35.8%)为女性;胆固醇水平为(4.01±0.88)mmol/L,CT检查见其中35例(32.1%)有冠状动脉钙化。74例CT检查未查见冠状动脉钙化,74例中有8例(11%)的被调查者冠状动脉狭窄>20%,其中5例(7%)冠状动脉狭窄≥50%;44例(59%)患者曾应用可卡因,应用过可卡因的患者中21例(28%)患者应用时间超过15年。109名被调查者,40例(36.7%)曾服用PI,在有和无冠状动脉斑块的被调查者中,血清高密度脂蛋白胆固醇(HDL)、吸食可卡因、年龄和服用PI有显著差异。应用Logistic回归模型分析发现使用PI和长期应用可卡因的时间是引起冠状动脉狭窄的独立相关因素。结论在HIV感染患者中,长期应用可卡因及同时使用PI可能与非钙化的冠状动脉斑块独立相关。
Objectives To investigate the use of enzyme inhibitors (PI) in recruiting black (aged) people aged 25 to 54 years old with or without HIV infection and / or cocaine use in Baltimore, Maryland, and whether coronary artery stenosis is present in long-term use of cocaine. Methods One hundred and niney 109-year-old, non-HIV-infected and / or cocaine-naïve youth aged 25- 54 years who were previously enrolled in Baltimore, MD, were enrolled in Baltimore, Maryland, Blood lipid and blood sugar were measured. The heart and coronary artery were scanned with 64-slice multi-slice CT. Logistic regression model was used to analyze the possible causes of coronary artery stenosis. Results The age of 109 respondents was 25 to 54 years old and 39 (35.8%) were women. The cholesterol level was (4.01 ± 0.88) mmol / L, and coronary artery calcification was found in 35 (32.1%) of the respondents. Coronary artery calcification was undetectable in 74 cases of CT, 8 (11%) of 74 (20%) had coronary stenosis> 5% (7%), 50% %) Patients had cocaine, and 21 (28%) of the patients who had used cocaine had been using for more than 15 years. Of the 109 respondents, 40 (36.7%) had taken PI and there was a significant difference in serum HDL, cocaine intake, age and taking PI among those with and without coronary plaque . Using Logistic regression model analysis found that the use of PI and long-term use of cocaine is an independent cause of coronary artery stenosis related factors. Conclusion Long-term use of cocaine and concurrent use of PI may be independently associated with non-calcified coronary plaques in HIV-infected patients.