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    不同种族冠心病患者心血管危险因素的对比研究

    Comparison of the cardiovascular risk factors for coronary artery disease patients among different races

    • 摘要: 目的 研究不同种族之间(中国与德国)不同年龄组冠心病心血管危险因素的分布情况并进行对比,希望对于个体化治疗提供帮助。方法 2016年2月—2017年7月收集中国东南大学附属第二医院新诊断为冠心病患者病例(共350例)与德国乌尔姆大学附属医院新诊断为冠心病患者病例(共300例),资料包括患者血糖、血脂、肌酐水平以及吸烟等不良生活方式。将650例患者分为<45岁(44例),45~59岁(112例),60~74岁(219例),≥75岁(275例)4个组进行比较。此外,进行Logistic回归分析,分析不同种族之间冠心病危险因素与冠状动脉病变严重程度之间的关联性。结果 <45岁年龄组中德冠心病患者在性别比例(P=0.019)和体重指数(BMI)(P=0.009)上差异有统计学意义;45~59岁年龄组中德冠心病患者在性别(P=0.002)、BMI(P=0.002)、C反应蛋白(CRP)(P=0.001)、总胆固醇(TC)(P=0.002)、高密度脂蛋白胆固醇(HDL-C)(P=0.000)以及吸烟(P=0.02)上差异有统计学意义;60~74岁年龄组中德冠心病患者在BMI(P=0.000)、糖尿病史(P=0.007)、空腹血糖(P=0.000)、CRP(P=0.011)、TC(P=0.000)、甘油三酯(TG)(P=0.025)、HDL-C(P=0.000)以及吸烟(P=0.002)上差异有统计学意义;≥75岁年龄组中德冠心病患者在BMI(P=0.001)、空腹血糖(P=0.000)、CRP(P=0.001)、TC(P=0.000)、TG(P=0.000)、HDL-C(P=0.000)、低密度脂蛋白胆固醇(LDL-C)(P=0.001)以及吸烟(P=0.016)、冠状动脉严重程度(P=0.000)上差异有统计学意义。中国组冠心病严重程度与年龄(P=0.012)、性别(P=0.003)、高血压(P=0.001)及糖尿病(P=0.006)相关,德国组冠心病严重程度与高血压(P=0.031)、糖尿病(P=0.001)及肌酐(P=0.039)相关。结论 不同种族之间(中国与德国)不同年龄组冠心病心血管危险因素的分布情况不同。种族差异可能影响冠状动脉疾病的危险因素与该病的发病机制和严重程度之间的联系。不同种族之间的差异促使患者需要个体化治疗,也就是说,不同的患者需要不同的指导方针。

       

      Abstract: Objective To investigate the distribution of cardiovascular risk factors of coronary heart disease among different races(China and Germany)in different age groups,so as to provide support for individualized treatment. Methods Clinical data were collected from coronary heart disease patients who were newly diagnosed in our hospital(n=350)and the Affiliated Hospital of University of Ulm in Germany(n=300)from February 2016 to July 2017.The patients were divided into four groups according to their ages:<45 years old(n=44),45-59 years old(n=112),60-74 years old(n=219)and ≥ 75 years old(n=275).Furthermore,a logistic regression analysis was performed to determine the associations between cardiovascular risk factors and the severity of coronary lesions in different races.Results For the<45 years old group,both Chinese and German patients with coronary heart disease presented significant differences in gender(P=0.019)and body mass index(BMI)(P=0.009).For the 45-59 years old group,both Chinese and German patients with coronary heart disease presented significant differences in gender(P=0.002),BMI(P=0.002),C-reactive protein(CRP)(p=0.001),total cholesterol(TC)(p=0.002),high density lipoprotein cholesterol(HDL-C)(P=0.000)and smoking(P=0.02).For the 60-74 years old group,both Chinese and German patients with coronary heart disease presented significant differences in BM1(P=0.000),diabetes mellitus(P=0.007),fasting blood glucose(P=0.000),CRP(P=0.011),TC(P=0.000),triglycerides(TG)(P=0.025),HDL-C(P=0.000)and smoking(P=0.002).For the ≥75 years old group,significant differences were found in BMI(P=0.001),fasting blood glucose(P=0.000),CRP(P=0.001),TC(P=0.000),TG(P=0.000),HDL-C(P=0.000),low density lipoprotein cholesterol(LDL-C)(P=0.001),smoking(P=0.016)and the severity of coronary artery(P=0.000).For Chinese patients,the severity of coronary artery was related to age(P=0.012),gender(P=0.003),hypertension(P=0.001)and diabetes mellitus(P=0.006).For German patients,the severity of coronary artery was related to hypertension(P=0.031),diabetes mellitus(P=0.001)and creatinine(P=0.039).Conclusions The cardiovascular risk factors for coronary heart disease vary among different ethnic groups(China and Germany)at different ages.Race differences may influence the association between risk factors for coronary artery disease and its pathogenesis and severity.In light of these differences,individualized treatment is required.

       

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