| 摘要: |
| 目的:研究急性胆囊炎且高度怀疑冠状动脉粥样硬化性心脏病(CHD)患者合并严重冠脉病变的比例、临床特点及相关危险因素。方法:回顾性选取天津市中西医结合医院2018年1月—2024年6月收治的因术前高度怀疑合并CHD而行冠脉造影检查的患者419例，其中冠脉严重狭窄组204例(3支冠脉主支任一支狭窄超过75%)，非严重冠脉病变组215例(狭窄<75%或无显著狭窄者)，比较两组临床特点，分析急性胆囊炎合并严重冠脉病变的影响因素。结果:严重冠脉病变组的年龄、男性比例、2型糖尿病史、肌酐(Cr)水平高于非严重冠脉病变组，体质量、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、左室射血分数(EF)低于非严重冠脉病变组，差异有统计学意义(P <0.05)。多因素Logistic回归分析显示:男性、年龄大、2型糖尿病病史是急性胆囊炎患者合并冠脉严重病变的独立危险因素，体质量小、左心房前后径小是急性胆囊炎患者冠脉发生严重病变的保护因素。结论:对男性、年龄大、2型糖尿病病史的胆石性急性胆囊炎患者，应警惕其合并严重冠脉病变的可能，必要时应根据冠脉造影检查结果制定恰当的治疗方案。 |
| 关键词: 急性胆囊炎 冠状动脉粥样硬化性心脏病 危险因素 |
| DOI：10.3969/j.issn.1007-6948.2025.05.012 |
| 投稿时间：2025-02-25 |
| 基金项目: |
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| Clinical characteristics and risk factors of patients with acute cholecystitis combined with severe coronary artery lesions |
| ZHANG Ling,ZHU Wen-cheng,ZHANG Hong |
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| Abstract: |
| Objective To explore the proportion, clinical characteristics and related risk factors of patients with acute cholecystitis combined with severe coronary lesions. Methods A total of 419 patients who were admitted to the Tianjin Hospital of ITCWM Hospital from January 2018 to June 2024 with a diagnosis of acute cholecystitis due to gallstones and planned for cholecystectomy, and who were highly suspected of coronary heart disease and underwent coronary angiography to assess surgical risk before surgery, were selected. According to the results of coronary angiography (CAG), patients were divided into two groups based on whether any of the three main branches of the coronary artery (anterior descending branch, circumflex branch, right coronary artery) had a stosis of more than 75%. The two groups were the non-severe coronary artery stenosis group (n=215) and the severe coronary stenosis group (n=204). The clinical characteristics of the two groups were observed, and the related risk factors were analyzed. Results The age, male proportion, history of type 2 diabetes, and Cr level were higher in the severe coronary artery lesion group than in the non-secoronary artery lesion group, and the body mass, TC, HDL, LDL, and EF were lower than in the non-severe coronary artery lesion group, statistically significant differences (P <0.05). Multivariate logistic regression analysis:Male, older age, and history of type 2 diabetes are the independent risk factors of severe coronary artery lesions in patients with acute cholecystitis. Small body mass and small left atrial anterior-posterior diameter are protective factors for severe coronary artery lesions patients with acute cholecystitis. Conclusions In patients with cholecystitis, male, old age, and a history of type 2 diabetes, attention should be paid to the presence of severe coronary lesions, and if necessary, appropriate treatment should be formulated according to the results of coronary angiography. |
| Key words: Acute cholecystitis coronary heart disease risk factors |
