冠心病患者冠状动脉钙化的临床危险因素分析

Analysis of risk factors associated with coronary artery calcification in coronary heart disease patients

    摘要
  • 摘要:
    目的 基于CT探究冠心病患者冠状动脉钙化（CAC）的发生率及临床危险因素。
    方法 回顾性分析 2019年1月至2022年12月重庆医科大学附属永川医院心内科收治的865例冠心病患者的临床资料，其中男性518例、女性347例，年龄（71.4±10.4） 岁。所有患者均行胸部CT平扫检查，根据显像结果将患者分为CAC组（n=592）和非CAC组（n=273），并计算CAC的发生率。采用单因素分析2组患者的年龄、性别、吸烟史、饮酒史、高脂血症史、糖尿病史、高血压病史、慢性肾脏病（CKD）史、慢性阻塞性肺疾病（COPD）史、长期他汀类药物服用史，糖化血红蛋白、低密度脂蛋白胆固醇（LDL-C）、甘油三脂（TG）水平，收缩压、冠心病类型等临床资料，确定CAC的危险因素。将单因素分析中差异有统计学意义的危险因素纳入多因素Logistic回归分析，筛选出独立危险因素。2组间的比较采用独立样本t检验或χ2检验。
    结果 在865例冠心病患者中，CAC的发生率为68.4%（592/865）。CAC组和非CAC组临床资料的单因素分析结果表明，年龄、性别、高血压病史、CKD史、糖尿病史、长期他汀类药物服用史、LDL-C水平、TG水平、收缩压、稳定型心绞痛是CAC的危险因素（t=2.534~4.094，χ2=4.441~11.961，均P<0.05）。多因素Logistic回归分析结果表明，年龄（OR=1.030，95%CI：1.014~1.045，P<0.001）、CKD史（OR=0.567，95%CI：0.338~0.951，P=0.031）、长期他汀类药物服用史（OR=0.655，95%CI：0.433~0.989，P=0.044）是CAC的独立危险因素。
    结论 CAC在冠心病患者中发生率较高；年龄、CKD史、长期他汀类药物服用史是预测CAC的独立危险因素。

     

    Abstract:
    Objective  To explore the incidence and clinical risk factors of coronary artery calcification (CAC) in patients with coronary heart disease based on CT.
    Methods  The clinical data of 865 patients with coronary heart disease admitted to the Department of Cardiology of Yongchuan Hospital of Chongqing Medical University from January 2019 to December 2022 were retrospectively analyzed, including 518 males and 347 females, aged (71.4±10.4) years. All patients were divided into CAC group (n=592) and non-CAC group (n=273) according to the imaging results, and the incidence of CAC was calculated. Clinical data such as the age, gender, smoking history, alcohol consumption history, hyperlipidemia history, diabetes history, hypertension history, chronic kidney disease (CKD) history, chronic obstructive pulmonary disease (COPD) history, long-term statin taking history, glycosylated hemoglobin, low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) levels, systolic blood pressure, the type of coronary heart disease were analyzed by univariate analysis to determine the risk factors of CAC. Risk factors with statistically significant differences in univariate analysis were included in multivariate Logistic regression analysis to screen for independent risk factors. Comparisons between the two groups were made using independent sample t-test or chi-square test.
    Results  In 865 patients with coronary artery disease, the incidence of CAC was 68.4% (592/865). There were statistically significant differences in age, gender, hypertension history, CKD history, diabetes history, long-term statin taking history, LDL-C level, TG level, systolic blood pressure and stable angina pectoris between CAC and non-CAC groups (t=2.534−4.094, χ2=4.441−11.961, all P<0.05). Age (OR=1.039, 95%CI: 1.014−1.045, P<0.001), CKD history (OR=0.567, 95%CI: 0.338−0.951, P=0.031), long-term statin taking history (OR=0.655, 95%CI: 0.433−0.989, P=0.044) were independent risk factors for CAC.
    Conclusions  CAC has a high incidence in patients with coronary artery disease. Age, CKD history, long-term statin taking history are independent risk factors for CAC.

     

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