Résumé
Objective To investigate the clinical characteristics of coronary heart disease risk fac tors,and explore the relationship of severity of coronary artery lesions in patients with coronary heart disease and coronary heart disease risk factors.Methods In our hospital for treatment of coronary artery disease patients during April 2013 to August 2014,230 cases of hospitalized patients were divided into two groups after coronary angiography diagnosis,including 170 cases of patients with coronary heart disease as the observation group,and 60 patients with coronary atherosclerosis as the control group with the degree of stenosis less than 50%.The clinical data of two groups were used to study the risk factors for coronary heart disease.The relationship was analyzed between severity of coronary artery pathological changes and coronary heart disease risk factors.Results For the observation group,type 2 diabetes,smoking,and men were associated with coronary heart disease (CHD),with the corresponding OR (95% CI) of 17.489 (11.013-30.017),48.632 (20.379-117.178),and 18.976 (13.105-28.331),respectively.Smoking and type 2 diabetes were associated with coronary artery stenosis degree (P < 0.05),with OR 95% (CI) of 10.15 (2.012-2.584),and of 7.23 (1.613-2.176).The results found there was no relationship among hypertension,dyslipidemia,coronary heart disease (CHD),and age.There was a link between the body mass index (BMI) and the severity of the disease.For observation group,left ventricular ejection function,high-sensitivity C-reactive protein (hs-CRP),and Ccr were related to the severity of coronary lesions,and the patients existed lower Ccr,left ventricular ejection function abate,and increased hs-CRP levels increase,P<0.05,and the OR (95% CI) were 1.986 (5.204-17.627),1.103 (1.012-1.027),and 2.131 (1.901-2.369).Conclusions Type 2 diabetes,smoking,male patients with coronary heart disease risk factors had a close relationship,and the severity of coronary artery lesions included the reduced re nal function in patients and the increased hs-CRP level.
Résumé
Objective To explore the risk factors related to death in patients with acute myocardial infarction(AMI) in hospital,so as to guide clinical treatment to reduce the occurrence of death.Methods Two hundred and seventy cases with AMI who got in infarction within 24 h were studied in the Cardiology Departmentof Zhongnan Hospital of Wuhan University from Jan.2010 and Jun.2013.The patients were divided into the death group(n =32) and the cured group(n =232) according to the endpoint in hospital.The clinical information was recorded and multiple factors logistic regression analysis was applied to analyze the risk factors of death due to AMI.Results The age,serum creatinine(Cr) in both groups were ((65.21 ± 13.55) years old,(76.41 ±10.19) years old) and ((100.23 ±65.99) μmol/L,(139.22 ±92.03) μmol/L) and there were statistically significant differences (P < 0.05).The differences of other indicators in two groups were no statistically significant.Clinical data comparison between the two groups showed that incidence rate of arrhythmia (14.7%),the disease rate of anterior descending coronary artery (50.4%),the disease rate of circumflex branch coronary artery (48.7%),the level of high sensitivity C reactionprotein (hs-CRP) ((5.92 ± 4.41) mg/L),brain natriuretic peptide (BNP) ((844.89 ± 1108.41) ng/L) and creatine kinase-MB (CK-MB) ((87.99 ± 140.45)U/L) in death group were lower than those in cured group (31.3%,81.3%,68.8%,(10.82 ± 2.29) mg/L,(1210.57 ± 984.44) ng/L,(161.86 ± 214.75) U/L; P < 0.05).Multiple factors logistic regression analysis showed that elder age (OR =1.078,95 % CI:1.014-1.118,P =0.015),arrhythmia occurred or not in hospital (OR =1.636,95% CI:1.151-3.041,P =0.024),the pathological changes of anterior descending coronary artery (OR =1.428,95 % CI:1.143-2.437,P =0.018),the level of hs-CRP (OR =1.352,95% CI:1.137-1.607,P =0.001) were the independent risk factors for myocardial infarction patients' death.Conclusion Elder age,arrhythmia occurred in hospital,the pathological changes of anterior descending coronary artery,the high level of hs-CRP are the independent risk factors for AMI patients death.Relevant measures in the treatment should be taken to reduce their risk of death.