大亚湾地区海岛渔民与大陆汉族冠心病患者临床特点及冠状动脉病变的对比分析

目的:探讨大亚湾地区海岛渔民与大陆汉族冠心病(CAD)患者临床特点及冠状动脉病变的差异。方法:选择性回顾2010年3月～2012年3月,在我院接受治疗的大亚湾地区CAD患者200例,其中当地海岛渔民100例,大陆汉族100例。对比分析两组病例的临床特点和冠状动脉病变特征。结果:吸烟、饮酒以及血脂异常是大亚湾地区海岛渔民冠心病患者主要危险因素,OR值分别达到3.69、2.83和2.59,具有统计学意义(P<0.05);男性、吸烟以及饮酒冠心病比率分别达到66.0%、42.0%和57.0%,显著高于大陆汉族冠心病患者(P<0.05),女性、肥胖、高血压、糖尿病、以及血脂异常渔民比率均显著低于大陆组(P<0.05);TG为2.47±0.73(mmol/L),显著高于大陆组(P<0.05);HDL-C为0.89±0.32(mmol/L),显著低于大陆组(P<0.05);单支病变例率为70.0%,显著高于大陆组(P<0.05),多支病变例数为30.0%,显著低于大陆组(P<0.05);LCX部位病变率为30.0%,显著高于大陆组(P<0.05),而LAD部位病变率为32.0%,显著低于大陆组(P<0.05)。结论:与大陆汉族比较大亚湾地区海岛渔民的主要危险因素是吸烟、饮酒和以TG升高以及HDL-C为主的血脂异常,其临床特点为男性患者比例高,肥胖、高血压和糖尿病发生率低,冠状动脉病变主要为单支为主,受累部位主要为左前降支和左回旋支,提示冠心病的危险因素及其临床特征及冠状动脉病变特点可能具有地域性差异。

Comparison of clinical characteristics and coronary artery lesions between fishermen of Dayawan island and han nationality of mainland patients with coronary artery disease

Objective: To compare the clinical characteristics and coronary artery lesions between fishermen of Dayawan island and Han nationality of mainland patients with CAD.Methods: Data of 200 cases of CAD patients that were treated in our hospital from March 2010 to March 2012 were retrospectively analyzed,of which 100 were fishermen came from Dayawan,and the other 100 cases were Han nationality came from mainland.The clinical characteristics and coronary artery lesion between two groups were compared.Results: Smoking,drinking and dyslipidemia were three risk factors for CAD in the fishermen group.The OR value of three risk factors were reached 3.69,2.83 and 2.59 respectively,showing statistical significance(P<0.05).In the fishermen CAD group,66% were male,42% patients were smoker and 57% drink alcohol,all significantly higher than the mainland Han patients group(P<0.05).The rate of female,obesity,hypertension,diabetes,and dyslipidemia in the fishermen group were significantly lower than those of the mainland group(P<0.05).The TG of he fishermen group was(2.47± 0.73) mmol/L,significantly higher than that of the mainland group(P<0.05) and the HDL-C was(0.89± 0.32) mmol/L,significantly lower than that of the mainland group(P<0.05).The single branch lesion case rate of the fishermen group was 70%,significantly higher than the mainland group(P<0.05) and the multivessel disease cases of fishermen group was 30%,significantly lower than the mainland group(P<0.05).The LCX lesions rate of fishermen group was 30%,significantly higher than the mainland group(P<0.05) and the LAD lesions rate of fishermen group was 32%,significantly lower than the mainland group(P<0.05).Conclusions: Smoking,drinking and dyslipidemia,increasing TG and HDL-C were the main risk factors of CAD among fishermen of Dayawan.It clinical features was high proportion of male patients,and low proportion of obesity,hypertension and diabetes.The coronary artery lesions mainly are single affected areas,in most of which left anterior descending and left circumflex artery are involved indicating risk factors and CAD lesions differ among different region.