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目的:探讨冠心病合并代谢综合征(metabolic syndrome,MS)患者的冠脉病变特点及冠心病与MS各组分的相关性。方法:选取540例冠心病患者为研究对象,其中合并MS患者164例,非合并MS患者376例,并将所有患者根据MS的组分个数进行分组,比较冠心病合并MS的病变特点、MS组分个数对冠状动脉病变程度的影响及冠状动脉病变程度与代谢综合症各组分的相关性;结果:①冠心病合并MS组BMI、FBG、TG、LDL-C、TC、UA、FIB、高血压分级等指标较非MS组高,差异有统计学意义(P<0.01),HDL-C、LVEF较非MS组低,差异有显著性(P<0.01);②MS组冠脉Gensini积分较高,三支病变、主干病变发生率高,差异有显著性(P<0.01);③随着合并MS组分个数的增加,冠脉Gensini积分也逐渐增加,各组间比较有显著性差异(P<0.01);④冠脉Gensini积分与MS组分BMI、高血压分级、TG、TC、LDL-C、UA等指标存在正相关(P<0.05),与性别、HDL-C存在负相关(p<0.01);调整传统危险因素后,Gensini积分与MS的组分数显著相关(r=0.739、P<0.01)。结论:冠心病患者有较高的MS患病率,冠心病合并MS患者冠脉病变程度更重,且以多支病变、主干病变为主;随着合并MS组分个数的增加,冠脉病变程度也呈加重趋势;MS的各个组分均与冠状动脉病变程度显著相关,可以作为冠心病严重程度的预测指标。
Objective: To investigate the characteristics of coronary lesions in patients with coronary heart disease complicated with metabolic syndrome (MS) and the correlation between coronary heart disease and various components of MS. Methods: A total of 540 patients with coronary heart disease were selected as the study subjects, including 164 patients with MS and 376 patients without MS. All patients were divided into groups according to the number of MS. The pathological features of MS were compared. MS The number of the components on the degree of coronary artery lesions and the degree of coronary artery disease and metabolic syndrome components of the correlation; Results: ① coronary heart disease with MS group BMI, FBG, TG, LDL-C, TC, UA, FIB (P <0.01). HDL-C and LVEF were lower than those in non-MS group (P <0.01). ②Comparison of coronary artery Gensini score (P <0.01) .③With the increase of the number of combined MS, coronary Gensini score also increased gradually, and there was significant difference among the three groups (P <0.01) .④The positive correlation between coronary Gensini score and BMI, hypertension grade, TG, TC, LDL-C, UA and other indicators of coronary artery was significant (P <0.01). After adjustment for traditional risk factors, Gensini score was significantly correlated with the fraction of MS (r = 0.739, P <0.01). Conclusion: Patients with coronary heart disease have a higher prevalence of MS. Patients with coronary artery disease and MS have a more severe coronary artery lesion with multi-vessel disease and trunk lesion. With the increase of the number of combined MS, The severity of coronary artery disease was also aggravating. The components of MS were significantly correlated with the severity of coronary artery disease and could be used as predictors of the severity of coronary heart disease.