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目的:分析肥胖患者的非ST段抬高急性冠状动脉综合征的临床特征和结局。方法:①不稳定心绞痛/非ST段抬高心肌梗死治疗策略登记注册研究回顾性登记了首都医科大学附属北京安贞医院心内科2000-01/2002-12首次因不稳定性心绞痛或非ST段抬高心肌梗死住院的患者1013例,记录患者临床特点、治疗方法以及住院事件的发生率等情况。②纳入不稳定心绞痛/非ST段抬高心肌梗死治疗策略登记注册中有体质量、身高记录的患者869例,其中肥胖患者480例,非肥胖患者389例,比较肥胖患者与非肥胖患者的危险因素特征。结果:不稳定心绞痛/非ST段抬高心肌梗死治疗策略登记注册中有体质量、身高记录的患者869例进入结果分析。①肥胖患者年龄明显小于非肥胖患者(P<0.01),既往有高血压史者明显多于非肥胖患者(P=0.028),而有吸烟史、糖尿病史、脑卒中史、周围血管病史、冠心病家族史比例差异不明显。②肥胖患者的舒张压、三酰甘油、总胆固醇、尿酸、肌酐水平、白细胞计数明显高于非肥胖者(P<0.05～0.01),高密度脂蛋白胆固醇明显低于非肥胖者(P<0.01)。③肥胖和非肥胖患者冠状动脉三支或左主干发生病变及院内不良心脏事件的发生率比例差异不明显(43.1%,2.7%;38.9%,4.1%,P<0.05);肥胖患者的血运重建的比例明显高于非肥胖者(79.4%,70.3%,P=0.006)。结论:①在非ST段抬高的冠状动脉综合征患者中,肥胖患者的年龄较轻,具有舒张压高、三酰甘油和总胆固醇高而高密度脂蛋白胆固醇低、尿酸水平高的特点,同时白细胞总数也高,说明伴有肥胖的非ST段抬高的冠状动脉综合征患者更多地具备了代谢综合征的特点。②未发现肥胖患者不良心脏事件发生率高。
OBJECTIVE: To analyze the clinical features and outcomes of non-ST-elevation acute coronary syndrome in obese patients. Methods: ①Study on treatment strategy of unstable angina pectoris / non-ST-segment elevation myocardial infarction (MI). A retrospective review of the registry of cardiology of Beijing Anzhen Hospital, Capital Medical University from January 2000 to December 2002 was performed for the first time because of unstable angina or non-ST segment 1013 cases of myocardial infarction hospitalized patients, record the clinical characteristics of patients, treatment and incidence of hospitalized cases and so on. ② included in the treatment of unstable angina pectoris / non-ST-segment elevation myocardial infarction strategy registration of patients with body mass, height records of patients with 869 cases, including 480 obese patients, 389 non-obese patients, compared obese patients with non-obese patients Factor characteristics. Results: 869 cases of patients with unstable angina pectoris / non-ST-segment elevation myocardial infarction with registration of body mass and height entered the result analysis. ① obese patients were significantly younger than non-obese patients (P <0.01), history of hypertension was significantly higher than that of non-obese patients (P = 0.028), but smoking history, history of diabetes, history of stroke, history of peripheral vascular disease, Family history of heart disease, the difference was not obvious. The diastolic blood pressure, triglyceride, total cholesterol, uric acid, creatinine, leukocyte count in obese patients were significantly higher than those in non-obese patients (P <0.05-0.01), and HDL cholesterol was significantly lower than those in non-obese patients ). (3) There was no significant difference in the incidence of coronary artery or left main coronary artery disease and hospital adverse cardiac events between obese and non-obese patients (43.1%, 2.7%; 38.9%, 4.1%, P <0.05) The rate of reconstruction was significantly higher than that of non-obese (79.4%, 70.3%, P = 0.006). Conclusion: Among patients with non-ST-elevation coronary syndrome, obese patients are younger and have the characteristics of high diastolic blood pressure, high triglyceride and total cholesterol, low HDL cholesterol and high uric acid levels, At the same time the total number of leukocytes is also high, indicating that patients with non-ST segment elevation coronary syndrome with obesity more with the characteristics of the metabolic syndrome. ② not found in obese patients with high incidence of adverse cardiac events.