膳食抗氧化指数与老年冠心病患者冠状动脉狭窄程度的关系 ^*

Relationship between dietary antioxidant index and degree of coronary artery stenosis in elderly patients with coronary heart disease

摘要

目的 探讨膳食抗氧化指数 (DAI) 与老年冠心病患者冠状动脉狭窄程度及预后的关联。方法 纳入 2022 年 1 月—2024 年 1 月行冠状动脉造影的 206 例老年患者, 根据狭窄程度分为冠心病组 (冠状动脉狭窄≥50%, 62 例) 和对照组 (冠状动脉狭窄<50%, 144 例), 冠心病组进一步按病变支数分为 1 支 (20 例)、2 支 (27 例)、≥3 支 (15 例) 三个亚组。采用食物摄入频率问卷计算 DAI 评分, 通过多因素 logistic 回归模型分析 DAI 与多支病变的关系。并对冠心病组获得有效随访的患者进行分析, 通过多因素 logistic 回归模型分析 DAI 与主要心血管不良事件 (MACE) 的独立关联。结果 冠心病组 DAI 评分低于对照组 (P<0.05), 且 DAI 评分随病变支数增加递减 (P<0.05)。多因素 logistic 回归显示, DAI 评分降低是冠心病患者多支病变发生的独立危险因素之一 (P<0.05)。随访显示, 57 例患者获得有效随访, DAI 评分越低的老年冠心病患者 MACE 的发生率越高, 多因素 logistic 回归分析结果显示, DAI 评分是影响 MACE 发生的保护因素 (P<0.05), 年龄、≥3 支病变及低密度脂蛋白胆固醇均为影响 MACE 发生的独立危险因素 (P<0.05)。结论 老年冠心病患者 DAI 评分与冠状动脉狭窄程度及不良预后显著相关, 低 DAI 是多支病变和 MACE 的独立预测因子, 提示膳食抗氧化能力可能通过减轻氧化应激延缓冠状动脉病变进展, 为饮食干预疗法提供了新依据。

Abstract

Objective To investigate the association between dietary antioxidant index (DAI) and the degree of coronary artery stenosis and prognosis in elderly patients with coronary heart disease. Methods 206 elderly patients who underwent coronary angiography from January 2022 to January 2024 were included and divided into a CHD group (coronary artery stenosis≥50%, 62 cases) and a control group (coronary artery stenosis<50%, 144 cases) according to the degree of stenosis. The CHD group was further divided into single (20 cases), double (27 cases) and three (15 cases) subgroups according to the number of lesions. Food frequency questionnaire was used to calculate the DAI score, logistic regression was used to analyze the relationship between DAI and multi-vessel lesions, and the coronary heart disease group (57 cases) was followed up for a median of 12 months, and the independent association between DAI and major cardiovascular adverse events (MACE) was analyzed by a multivariate logistic regression model. Results The DAI score of the coronary heart disease group was lower than that of the control group (P<0.05), and the DAI score decreased with the increasing number of coronary artery disease lesions (P<0.05). Multivariate logistic regression showed that a decreased DAI score was one of the independent risk factors for multi-vessel lesions in patients with coronary heart disease (P<0.05). Follow-up showed that 57 patients were followed up. The lower the DAI bisection in elderly patients with coronary heart disease, the higher the incidence of MACE. The multivariate logistic regression indicated that the DAI score was a protective factor affecting the occurrence of MACE (P<0.05). Age, ≥3 vessel lesions and low-density lipoprotein cholesterol were all independent risk factors affecting the occurrence of MACE (P<0.05). Conclusion The DAI score of elderly patients with coronary heart disease is significantly correlated with the degree of coronary artery stenosis and poor prognosis. Low DAI is an independent predictor of multi-vessel disease and MACE, suggesting that dietary antioxidant capacity may delay the progression of coronary artery disease by reducing oxidative stress, providing a new basis for dietary intervention.

关键词

冠心病 / 膳食抗氧化指数 / 冠状动脉狭窄

Key words

Coronary heart disease / Dietary antioxidant index / Coronary artery stenosis

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基金资助

^*国家卫健委 “十三五” 规划重点课题(NHFPC102018)

2023 年东莞市社会发展科技重点项目(20231800940162)