不稳定心绞痛危险分层与心脑血管病的相关性分析 不稳定型心绞痛
[摘要] 目的 探讨心绞痛危险分层与心脑血管病的相关性。 方法 对2010年1月～2011年5月来我院诊治的180例不同危险分层的心绞痛患者，分别进行QRS波碎裂、缺血修饰蛋白（IMA）、钠尿肽（BNP）、动脉粥样斑块及内膜-中膜厚度（IMT）的检测，利用冠脉造影对冠脉病变支数和冠脉狭窄程度进行检测，以及经颅多普勒（TCD）检查。 结果 与低危组（21.7%）相比，中危组（43.3%）、高危组（65.0%）出现QRS波碎裂的发生率明显增多（P < 0.05）。与低危组相比，中、高危组IMA水平明显升高（P < 0.05）。与低危组相比，中、高危组钠尿肽BNP明显提高（P < 0.05）。随着危险分层的增高，冠脉动脉病变支数逐渐由单支病变转变为多支病变，冠脉狭窄程度逐渐增加，TCD检查异常率升高。 结论 心绞痛危险分层越高，发生心脑血管病的几率就越高。
[关键词] 心绞痛；危险分层；心脑血管病；相关性
[中图分类号] R541.4 [文献标识码] A [文章编号] 1673-7210（2012）08（b）-0050-03
Correlation analysis of the risk stratification of unstable angina with cardio-cerebrovascular disease
YUAN Muxiang
The First People′s Hospital of Xiantao City, Hubei Province, Xiantao 433000, China
[Abstract] Objective To study the correlation of the risk stratification of unstable angina with cardio-cerebrovascular disease. Methods 180 angina patients with different risk stratification during the period from January 2010 to May 2011 in our hospital were measured respectively QRS complex fragmentation, ischemia-modified protein (IMA), natriuretic peptide (BNP), atherosclerotic plaque and intima-media thickness (IMT). The coronary lesions and coronary stenosis were detected by coronary angiography, TCD measures were assayed by transcranial Doppler examination. Results Compared with the low risk group (21.7%), the QRS complex fragmentation was significantly increased in middle and high risk groups (43.3% and 65.0%) (P < 0.05). Compared with the low risk group, the IMA levels increased significantly in middle and high risk groups (P < 0.05). Compared with the low risk group , the natriuretic peptide BNP significantly increased in middle and high risk groups (P < 0.05). With the increase of the risk stratification, the coronary arterial lesions gradually shifted from single-vessel disease with multivessel disease, the abnormal TCD rate increased with the coronary artery stenosis gradually increased. Conclusion With the higher the risk stratification of angina, the cardio-cerebrovascular disease is the higher occurrence. [Key words] Angina; Risk stratification; Cardio-cerebrovascular; Correlation
近年来，国内外流行病学调查报告和临床医学统计证实，心脑血管病是当前影响人类健康，危害人类生命最重、发病率最高、死亡率最高、致残率最高的三大疾病之一[1]。因此，心脑血管病受到国内外有关部门的高度重视。动脉粥样硬化斑块导致冠状动脉缺血，从而形成心绞痛，这与导致各种心脑血管疾病的危险因素密切相关[2]。本研究对2010年1月～2011年5月于我院诊治的180例不同危险分层的心绞痛患者的临床资料进行回顾性分析。现将结果报道如下，以供临床参考。
1 资料与方法
1.1 一般资料
选取2010年1月～2011年5月于我院诊治的180例心绞痛患者，其中，男104例，女76例，年龄38.4～67.3岁。所有患者均符合WHO 冠心病心绞痛诊断标准与分型，并经心电图和心肌酶谱检查排除心肌梗死。根据患者病情的严重程度、体征和心电图等检查结果，将180例心绞痛患者分为三组（低危组、中危组和高危组），每组各60例。三组在年龄和性别比方面比较差异无统计学意义（P ＞ 0.05），具有可比性。