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目的探讨特发性二尖瓣腱索断裂患者心血管病危险因素与冠状动脉(冠脉)造影结果的相关性。方法入选行冠脉造影的特发性二尖瓣腱索断裂患者195例,其中冠脉造影正常组143例(占74.33%),冠脉造影异常组(即确诊合并有冠心病)52例(占26.67%)。危险因素包括性别、年龄、吸烟史、高血压病、2型糖尿病、缺血性心血管病家族史、血脂异常、高尿酸血症、血红蛋白、总胆红素、体重指数。采用单因素和多因素分析。结果 (1)单因素分析显示,合并冠心病组发病年龄较冠脉造影正常组大,合并冠心病组吸烟比例、高血压病史比例、缺血性心血管病家族史比例、总胆固醇水平、甘油三酯水平、低密度脂蛋白胆固醇水平、尿酸水平均显著高于冠脉造影正常组。(2)多因素Logistic回归分析显示,缺血性心血管病家族史是特发性二尖瓣腱索断裂患者合并冠心病最显著的独立相关危险因素(OR=29.628,95%可信区间8.234-106.604,P=0.001),其它危险因素依次为高血压病史、高尿酸血症。结论缺血性心血管病家族史是特发性二尖瓣腱索断裂患者合并冠心病的独立相关危险因素,对于合并有冠心病高危因素(如高龄、有高血压病史、高尿酸、吸烟史、高脂血症)的特发性二尖瓣腱索断裂患者术前应完善冠脉造影检查,明确有无合并冠脉造影异常,以便制定合理手术方案。
Objective To investigate the relationship between cardiovascular risk factors and coronary artery (coronary) angiography in patients with idiopathic mitral chordal tendon rupture. Methods One hundred and ninety-five patients with idiopathic mitral chordae tendinotomy undergoing coronary angiography were enrolled. Among them, 143 cases (74.33%) had normal coronary angiography, 52 cases had abnormal angiography (diagnosed with coronary heart disease) Accounting for 26.67%). Risk factors include gender, age, smoking history, hypertension, type 2 diabetes, family history of ischemic cardiovascular disease, dyslipidemia, hyperuricemia, hemoglobin, total bilirubin, body mass index. Univariate and multivariate analyzes were used. Results (1) Univariate analysis showed that the age of onset of CHD group was larger than that of normal coronary angiography group, smoking history, proportion of history of hypertension, family history of ischemic cardiovascular disease, total cholesterol, Triester levels, LDL cholesterol levels and uric acid levels were significantly higher than those of coronary angiography. (2) Multivariate Logistic regression analysis showed that family history of ischemic cardiovascular disease was the most significant independent risk factor for coronary heart disease in patients with idiopathic mitral chordae tendinosis (OR = 29.628, 95% CI 8.234 -106.604, P = 0.001), followed by other risk factors for the history of hypertension, hyperuricemia. Conclusions The family history of ischemic cardiovascular disease is an independent risk factor for coronary heart disease in patients with idiopathic mitral chordae tendinopathy. There is a significant association between the risk factors of coronary heart disease and coronary heart disease (such as advanced age, history of hypertension, hyperuricemia, smoking history , Hyperlipidemia) of idiopathic mitral chordae tendinosis patients should improve coronary angiography before surgery to determine whether the merger of coronary angiography anomalies in order to develop a reasonable surgical plan.