2022 年第 9 期 第 17 卷

青年冠心病患者中代谢综合征与罪犯病变斑块表型的相关性

Correlation between metabolic syndrome and culprit plaque phenotype in young patients with coronary atherosclerotic heart disease

作者：侯方杰王正忠耿强马颖范树信赵凯迪许耀文骆效青高杰管军王国安

英文作者：Hou Fangjie Wang Zhengzhong Geng Qiang Ma Ying Fan Shuxin Zhao Kaidi Xu Yaowen Luo Xiaoqing Gao Jie Guan Jun Wang Guoan

单位：山东省青岛市市立医院心内科，青岛266000

英文单位：Department of Cardiology Qingdao Municipal Hospital Shandong Province Qingdao 266000 China

关键词：冠心病（冠状动脉粥样硬化性心脏病）；代谢综合征；光学相干断层成像

英文关键词：Coronaryatheroscleroticheartdisease;Metabolicsyndrome;Opticalcoherencetomography

• 摘要：

• 目的 探讨青年冠心病（冠状动脉粥样硬化性心脏病）患者中代谢综合征（MS）与罪犯病变斑块表型的相关性。方法  回顾性选取2019年4月至2021年10月在山东省青岛市市立医院接受光学相干断层成像（OCT）检查的青年冠心病患者（≤45岁）132例。根据是否合并MS分为MS组（90例）和非MS组（42例）。比较2组患者OCT下的斑块特征，分析薄纤维帽粥样硬化斑块（TCFA）的独立预测因子。结果  MS组TCFA比例高于非MS组［80.0%(72/90)比54.8%（23/42）］，差异有统计学意义（P=0.004）。多因素分析结果显示，MS和吸烟均是青年冠心病患者TCFA的独立预测因子（比值比=2.722，95%置信区间：1.167～6.349、P=0.020；比值比=2.235，95%置信区间：1.001～4.993、P=0.048）。结论 青年冠心病患者中合并MS和吸烟者罪犯病变中有更多的TCFA。

• Objective  To investigate the correlation between metabolic syndrome (MS) and culprit plaque phenotype in young patients with coronary atherosclerotic heart disease. Methods  Totally 132 young patients (≤ 45 years old) with coronary atherosclerotic heart disease who underwent optical coherence tomography (OCT) in Qingdao Municipal Hospital, Shandong Province from April 2019 to October 2021 were retrospectively selected. According to whether MS was combined or not, the patients were divided into MS group (90 cases) and non MS group (42 cases). The plaque characteristics under OCT were compared between the two groups, and the independent predictors of thin fibrous cap atherosclerotic plaque (TCFA) were analyzed. Results  The proportion of TCFA in MS group was higher than that in non MS group ［80.0%(72/90) vs 54.8%(23/42)］(P=0.004). Multivariate analysis showed that MS and smoking were independent predictors of TCFA in young patients with coronary atherosclerotic heart disease (odds ratio=2.722, 95% confidence interval: 1.167-6.349, P=0.020; odds ratio=2.235, 95% confidence interval: 1.001-4.993, P=0.048). Conclusion  There are more TCFA in young patients with coronary atherosclerotic heart disease complicated with MS and smoking.