降主动脉扩张性疾病合并冠心病患者临床特点分析

目的 分析降主动脉扩张性疾病患者合并冠状动脉粥样硬化性心脏病（冠心病）的发病率、发病危险因素及临床特点,为今后的诊断、治疗提供参考.方法 回顾性分析2002年4月至2013年10月在沈阳军区总医院心内科住院,同时行降主动脉扩张性疾病介入诊治术及冠状动脉造影术患者427例的临床资料.根据冠状动脉造影结果分为冠心病组与非冠心病组,比较两组患者的基线资料、临床特点.结果 冠心病组患者138例（32.32％）,其中单支血管病变79例（占冠心病患者57.25％）,双支血管病变37例（占冠心病患者26.81％）,三支血管病变22例（占冠心病患者15.94％）（包括合并左主干病变4例）.非冠心病组患者289例（67.68％）,其中冠状动脉狭窄＜50％的患者50例（11.71％）,冠状动脉正常的患者239例（55.97％）.冠心病组比非冠心病组年龄大（60.62±9.66）岁vs.（55.12±11.42）岁,P＜0.001],≥60岁的老年患者比例高（50.72％vs.32.53％,P＜0.001）,并发糖尿病（8.70％ vs.2.77％,P=0.012）及脑血管病（19.57％ vs.11.76％,P=0.038）的患者比例多,高三酰甘油血症发病率高（26.81％ vs.14.53％,P=0.005）,血浆纤维蛋白原含量高（5.41±2.94）g/L vs.（4.88±1.93）g/L,P=0.037],差异均有统计学意义.非冠心病组患者白细胞计数（10.33±3.55） ×10^9/Lvs.（9.55 ±3.17）×10^9/L,P=0.029]、肌酸激酶（128.29±149.95）U/L vs.（98.92±102.05）U/L,P=0.038]及肌酸激酶同工酶（13.90±9.91）U/L vs.（11.59±5.15）U/L,P=0.010]高,主动脉破口距左锁骨下动脉外缘更近（15.92±22.98）mm vs.（24.74±29.78）mm,P=0.001],降主动脉扩张性疾病急性发病率高（66.09％ vs.54.35％,P=0.025）,差异均有统计学意义.两组并发高血压患者比例及高血压分级比较,差异无统计学意义（P＞0.05）.多因素Logistic回归分析结果显示,年龄（OR=1.049,95％CI：1.024-1.075,P＜0.001）、糖尿病史（OR=3.87

Clinical characteristics of patients with descending aortic dilatation disease and coronary heart disease

Objectives To evaluate the incidence,risk factors and clinical characteristics of coronary heart disease in patients with descending aortic dilatation disease （DADD） and provide some references for future diagnosis and treatment.Methods From April 2002 to October 2013,a total of 427 in-hospital patients with DADD receiving interventional therapy and coronary angiography in the General Hospital of Shenyang Military were enrolled in this study.The patients were divided into coronary heart disease group （CHD group） and non-coronary heart disease group （non-CHD group） by the angiographic results.Baseline data and clinical characteristics between the two groups were compared.Results Totally 138 （32.32%） patients were diagnosed as CHD by coronary angiography,of which,79 （57.25%） patients were with one-vessel lesion,37 （26.81%） patients were with two-vessel lesions and 22 （15.94%） patients were with three-vessel lesions （including 4 patients suffering from left main coronary artery disease）.Totally 289 （67.68%） patients were diagnosed as non-CHD by coronary angiography,of which,50 （11.71%） patients were with coronary artery stenosis〈50% and 239 （55.97%） patients were with normal coronary arteries.Compared with patients in non-CHD group,patients in CHD group were much older （60.62±9.66） years vs.（55.12±11.42） years,P〈0.001] and had significantly higher proportions of patients aged over 60 years （50.72% vs.32.53%,P〈0.001）,diabetes mellitus （8.70% vs.2.77%,P=0.012）,cerebrovascular diseases （19.57% vs.11.76%,P=0.038）,hypertriglyceridemia （26.81% vs.14.53%,P=0.005） and more plasma fibrinogen （5.41±2.94） g/L vs.（4.88±1.93） g/L,P=0.037].However,patients in non-CHD group had significantly higher white blood cell counts （10.33±3.55）×10^9/L vs.（9.55±3.17）×10^9/L,P=0.029],creatine kinase （128.29±149.95） U/Lvs.（98.92±102.05） U/L,P=0.038] and creatine kinase MB （13.90±9.91） U/Lvs.（11.59± 5.15） U/L,P=0.010],highe