Tehran University Medical Journal
مجله دانشکده پزشکی، دانشگاه علوم پزشکی تهران
Tehran Univ Med J
Medical Sciences
http://tumj.tums.ac.ir
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1683-1764
1735-7322
10.18869/acadpub.tumj
000
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fa
jalali
1390
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gregorian
2011
12
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69
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online
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fulltext
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ارتباط تنگی شریان کرونری اصلی چپ با سندرم متابولیک در بیماران ایسکمیک قلبی: مطالعه دو ساله
The effects of metabolic syndrome on left main coronary artery stenosis in coronary angiograms of patients: a two year study
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<p dir="rtl" style="text-align: justify direction: rtl unicode-bidi: embed" class="MsoNormal"><strong><span style="font-size: 10pt">زمینه و هدف:</span><em><span style="font-size: 10pt"> </span></em></strong><span style="font-size: 10pt color: black">گرفتگی کرونر اصلی چپ با مرگ و میر فراوان همراه و تشخیص زودرس آن میتواند از
مرگ و میر سالهای آتی جلوگیری نماید. عوامل خطرساز متابولیک و فیزیولوژیک بیماریهای
قلبی و عروقی تحت عنوان سندرم متابولیک نامیده میشود و ریسک فاکتور برای بیماریهای
عروقی کرونر است. تاثیر سندرم متابولیک بر گرفتگی کرونر اصلی چپ مشخص نبوده و هدف
این مطالعه ارزیابی این اثرات بر گرفتگی کرونر اصلی چپ است. </span><strong><em><span style="font-size: 10pt"><br></span></em></strong></p><p dir="rtl" style="text-align: justify direction: rtl unicode-bidi: embed" class="MsoNormal"><strong><span style="font-size: 10pt">روش بررسی:</span><em><span style="font-size: 10pt"> </span></em></strong><span style="font-size: 10pt color: black">تعداد 495 نفر
بیمار تحت آنژیوگرافی قرار گرفته و براساس تعاریف استاندارد جهانی سندرم متابولیک
در آنها مشخص شد و سپس در کل بیماران آنژیوگرافی شده میزان گرفتگی کرونر اصلی سمت
چپ و میزان همراهی آنها با هم و با ریسکفاکتورها سنجیده شد.</span><strong><span style="font-size: 10pt"> </span></strong><strong><span style="font-size: 10pt"><br></span></strong></p><p dir="rtl" style="text-align: justify direction: rtl unicode-bidi: embed" class="MsoNormal"><strong><span style="font-size: 10pt">یافتهها:</span></strong><span style="font-size: 10pt"> </span><span style="font-size: 10pt color: black">249 (3/50%) مرد و 246
(7/49%) زن بودند. میانگین سن آنها 10</span><span style="font-size: 8pt color: black">±</span><span style="font-size: 10pt color: black">01/58 بود. سندرم
متابولیک در 86 نفر (4/17%) حضور داشت. گرفتگی کرونر اصلی سمت چپ در 25 بیمار (5%)
حضور داشت. بین سندرم متابولیک و گرفتگی کرونر اصلی سمت چپ ارتباط معنیدار بود
012/0</span><span style="font-size: 7pt color: black">P=</span><span style="font-size: 10pt color: black">، 305/0</span><span style="font-size: 8pt color: black">r=</span><span style="font-size: 10pt color: black"> بین سن 05/0</span><span style="font-size: 7pt color: black">P=</span><span style="font-size: 10pt color: black">، 192/0</span><span style="font-size: 8pt color: black">r=</span><span style="font-size: 10pt color: black">، جنس 007/0</span><span style="font-size: 7pt color: black">P=</span><span style="font-size: 10pt color: black">، 334/0</span><span style="font-size: 8pt color: black">r=</span><span style="font-size: 10pt color: black"> دیابت 03/0</span><span style="font-size: 7pt color: black">P=</span><span style="font-size: 10pt color: black">، 253/0</span><span style="font-size: 8pt color: black">r=</span><span style="font-size: 10pt color: black"> و سیگار 03/0</span><span style="font-size: 7pt color: black">P=</span><span style="font-size: 10pt color: black">، 253/0</span><span style="font-size: 8pt color: black">r=</span><span style="font-size: 10pt color: black"> <span lang="FA">و گرفتگی کرونر اصلی سمت چپ ارتباط معنیدار بود.</span></span><strong><span style="font-size: 10pt"> <br></span></strong></p><p dir="rtl" style="text-align: justify direction: rtl unicode-bidi: embed" class="MsoNormal"><strong><span style="font-size: 10pt">نتیجهگیری:</span><em><span style="font-size: 10pt"> </span></em></strong><span style="font-size: 10pt color: black">سندرم متابولیک میتواند با گرفتگی کرونر اصلی سمت چپ همراه باشد. احتمال
همراهی سندرم متابولیک برای گرفتگی کرونر اصلی سمت چپ با افزایش قند خون، سن، جنس
مرد و استعمال سیگار وابسته است. این عوامل بهطور همکار ریسکفاکتور گرفتگی کرونر
اصلی سمت چپ را در بیماران سندرم متابولیک بالا میبرند.</span></p>
<p style="text-align: justify"><strong>Background:</strong><strong> </strong>Left main coronary artery (LMCA) stenosis is a leading cause of mortality and morbidity in many countries. Metabolic syndrome (MS) is a risk factor for coronary artery disease (CAD). The effects of MS on left main coronary artery stenosis are not well-defined. The aim of this study was to examine the effects of MS on left main coronary artery stenosis.<br><strong>Methods:</strong> <strong></strong>A total number of 495 patients who underwent elective coronary angiography in the Catheter Laboratory of Cardiovascular in Shariati Hospital 2008-2010 were included in the study. MS definition was based on the National Cholesterol Education Program (NCEP)- Adult Treatment Panel III (ATP III) criteria. The stenosis in left main coronary arteries was determined by examining the coronary angiograms of the patients.<br><strong>Results:</strong> <strong></strong>The study population consisted of 249 (50.3%) men, and 246 (49.7%) women. The mean age of the participants was 58.01±10 years. MS was present in 86 (17.4%) of the patients based on NCEP- ATP III criteria. LMCA stenosis was seen in 25 (5%) patients. A positive correlation was found between MS and LMCA stenosis (r=0.305, P=0.012). Moreover, a positive correlation was found between age (r=0.192, P=0.05), sex (r=0.334, P=0.007), smoking (r=0.336, P=0.01) and diabetes (r=0.253, P=0.03) and LMCA stenosis.<br><strong>Conclusion: </strong>The metabolic syndrome correlates with LMCA stenosis. LMCA stenosis and its correlation with MS is precipitated by high FBG, age, male sex, and smoking which may synergistically increase the risk for the disease.</p>
کرونر اصلی چپ،سندرم متابولیک،آنژیوگرافی
Angiography,left main coronary artery,metabolic syndrome
571
575
http://tumj.tums.ac.ir/browse.php?a_code=A-10-25-196&slc_lang=fa&sid=1
Mohagheghi
A
عباس
محققی