| Objective: In order to demonstrate the value of cardiovascular risk factors, this research is to discuss the relationship between common risk factors of coronary heart disease and characteristics of injured coronary artery, and the relationship between hyperuricacidemia, hypobilirubinemia which may be risk factors for coronary heart disease and injured coronary artery further for prevention and treatment of coronary heart disease.Methods: By retrospective case analysis, we studied 558 cases admitted in cardiology department and operated on coronary angiography from Jan. 1.2002 to March. 10.2005. The severity of coronary artery stenosis was measured though angiography image system. Coronary stenosis ≥50% enrolled in coronary artery disease group. No stenosis or stenosis <50% in control group, and the severity of lesion was graded. According to the luminar diameter of coronary artery, 50%-75%, 76%-90%, 91%-100% were defined as low-grade, middle-grade, high-grade stenosis respectively. According to the number of suffered coronary artery, single branch, double branches and several branches were defined. Coronary artery disease group was separated to diabetes group and non-diabetes group. Patients' preprandial blood was examed by routine assay. Results.1. Age and coronary pathological change Mean age is 55.47 + 11.08 years in control group, 61.08+10.28 years in coronary artery disease group. The latter's age is larger than the former's(P<0.001). Single branch group's is smallest. More several branches stenosis in the aging group. The more severe stenosis in the elder patients. It indicates that with the increase of ages coronary pathological range become larger and degree more severe.2. Sex and coronary pathological change The incidence of coronary stenosis inmen is higher than in women(86.15%vs67.86, P<0.001). high-grade stenosis is more familiar(75.34vs64.91, P<0.05). The proportion of sex in different pathological range is no significantly different(P>0.05).3.Smoking and coronary pathological change The incidence of coronary stenosis is higher in the smoker. The proportion of single branch in non-smoker is higher(36.25%vs25.00%, P<0.05). The proportion of high-grade stenosis in smoker is higher(84.58%vs59.05%, PO.05).4. Blood pressure and coronary pathological change The proportion of coronary artery disease combined with hypertension is higher(87.04%vs 12.96%, P<0.00). Mean systolic blood pressure in low-grade stenosis is lower than in high-grade stenosis(P<0.01), low-grade and middle-grade are no significantly different, middle-grade and high-grade are no significantly different, either(P<0.05). Mean diastolic blood pressure in high-grade stenosis is highest, but either group is no significantly different.5. Blood lipid and coronary pathological change The concentration of TC, TG, LDL-C, apoB in coronary artery disease group is higher than in control group(P<0.01 or P<0.05). The concentration of HDL-C,apoA-I in control group is higher than coronary artery disease group(P<0.001). The concentration of TC, TG, LDL-C, apoB in single branch group is higher than in several branch group (P<0.05). The concentration of HDL-C in single branch group is higher than in double and several branch groups (P<0.05). The concentration of apoA-I decreases gradually, but has no significant difference. The concentration of TC, TG, HDL-C is no significantly different between different grade stenosis (P>0.05). The concentration of LDL-C in high-grade is higher than in low-grade (P<0.05). Low-grade and middle-grade are no significantly different. Middle-grade and high-grade are no significantly different, either. The concentration of apoA-I in low-grade is higher than middle and high grade(P<0.05, P<0.01), and that inmiddle-grade is higher than in high-grade (P<0.05). The concentration of apoB in high-grade is higher than in low-grade with significant difference (P<0.01). Low-grade and middle-grade are no significantly different. Middle-grade and high-grade, either.6. Serum creatinine and coronary pathological change The concentration of creatinine in coronary artery disease group is higher than in control group(P<0.05). There are no significant difference in different coronary pathological range and grade.7. Serum uric acid and coronary pathological change The concentration of uric acid in coronary artery disease group is higher than in control group(P<0.001). The concentration of uric acid in several and double branch stenosis are higher than in single branch stenosis (P<0.05), and there are no significantly different between bouble and several branch stenosis. The concentration of uric acid in high-grade is higher than in low-grade (PO.05), and there are no significantly different between others.8. Serum total bilirubin and coronary pathological change The concentration of serum total bilirubin in coronary artery disease group is higher than in control group(P<0.05). There are no significantly difference in different coronary pathological range and grade.9. Correlation analysis and multifactor non-condition logistic regression analysis of risk factors and coronary pathological integralIt indicates by Spearman's correlation analysis a positive correlation was found between coronary pathological grade and hypertension, diabetes, smoking (r=0.136-0.334, P=0.001), a positive correlation between coronary pathological grade and age, systolic blood hypertension, diastolic blood hypertension, TC, TG, LDL-C, apoB, UA (r=0.020~0.26, P=0.000-0.042), a negative correlation between coronary pathological grade and female, HDL-C, apoA-I, TBIL(r=-0.418—0.07,P=0.000~0.001), no correlation between coronary pathological grade and serum creatinine. It indicates by multifactor non-condition logistic regression analysis female, HDL-C, apoA-I, TBIL are independent protecting factors for coronary artery change, and age. hypertension, smoking, diabetes, TC, apoB are independent risk factors.10. Diabetes and coronary pathological change Diabetes patients have 117 cases in our data, thereinto diabetes patients without coronary pathological change have 5 cases(4.27%), with coronary pathological change have 112 cases(95.73%), non-diabetes patients without coronary pathological change have 103 cases(23.36%), with coronary pathological change have 338 cases(76.64%), coronary pathological change in diabetes patients has higher proportion (95.73%vs76.64, PO.01). The level of systolic blood pressure, TC, UA in diabetes are higher than in non-diabetes with significant difference (P<0.05). The level of HDL-C, apoA-I in diabetes are lower than in non-diabetes with significant difference (P<0.05). No significant difference of diastolic blood pressure, TG, LDL-C, Cr, TBIL were found between two groups. No significant difference of coronary pathological position were found (P>0.05). No significant difference in the proportion coronary pathological grade were found (P>0.05). The incidence of complicated change in diabetes is higher (67.86%vs52.07%, PO.01). The incidence of multi-branch change in diabetes is higher (63.39%vs31.07%, PO.01). The incidence of diffuse change in diabetes is higher (41.07%vsl8.60, PO.01). The incidence of single-branch stenosis with less than five years' course is higher(22.58%vs6.17%, PO.01). The incidence of several-branch with more than five years' course is higher(38.71%vs72.83%, pO.01). Conclusions:1. Age, hypertension, smoking, diabetes, serum TC, apoB are independent risk factors for coronary artery disease. Female, HDL-C, apoA-I are independent... |
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