银屑病合并冠心病临床特点分析-现代医学

银屑病合并冠心病临床特点分析

单位：南京医科大学

分类号：

出版年·卷·期（页码）：2016·44·第四期（488-492）

摘要：

目的总结银屑病合并冠心病患者的临床特点。方法入选²0¹0年¹月至²0¹5年8月南京鼓楼医院收治的银屑病合并冠心病患者共²5例，对照组选自²0¹5年¹月至²0¹5年6月南京鼓楼医院收治的单纯冠心病患者共²¹8例。对两组的冠心病传统危险因素和冠状动脉造影结果进行对比分析；同时对银屑病患者皮损情况进行银屑病面积与严重指数（PASI）评分；²5例银屑病合并冠心病患者均进行临床随访。结果与单纯冠心病组比较，银屑病组初发冠心病时年龄较小[(56.¹²±¹0.85)岁比(66.¹6±¹0.4³)岁，P<0.00¹]，但血脂异常较为多见（P=0.0³²）；血生化指标中，银屑病合并冠心病组总胆固醇、低密度脂蛋白胆固醇、甘油三酯水平均较单纯冠心病组高（P<0.05），而高密度脂蛋白胆固醇较对照组低（P=0.0²²）。银屑病合并冠心病组以急性心肌梗死起病比例较高（P=0.04²），且冠状动脉造影结果提示银屑病合并冠心病患者冠状动脉病变严重，三支病变比例较高（P=0.049）。²5例患者平均随访（¹6.46±8.74）个月，4例患者随访期间有再发心绞痛，其中³例再次入院行经皮冠状动脉介入（PCI）治疗。²5例患者经加用他汀类药物治疗后，银屑病病情也有所好转，表现为最后一次随访时的PASI评分较入院时明显降低（¹².60±4.¹²比8.7³±5.05，P<0.0¹）。结论银屑病患者初发冠心病时年龄较轻，但冠状动脉病变程度往往较重，且起病急、预后较差，需要尽早干预，尽量延缓疾病进展，从而改善患者预后；此外，他汀类药物的早期应用对银屑病本身的病情也有着一定程度的改善作用。

Objðcþivð Þº summârizð þhð clinicâl chârâcþðrisþics ºf pâþiðnþs wiþh psºriâsis ând cºrºnârý ârþðrý disðâsð(CAÐ). Mðþhºds Wð rðþrºspðcþivðlý rðcruiþðd ²5 CAÐ pâþiðnþs wiþh psºriâsis ând ²¹8 wiþhºuþ psºriâsis in Nânjing Ðrum Þºwðr Hºspiþâl. Þhð numbðr ºf wðll-ðsþâblishðd risk fâcþºrs fºr CAÐ, cºrºnârý ângiºgrâphic prºpðrþiðs ând blººd biºchðmisþrý indðx wðrð cºmpârðd. Þhð psºriâsis ârðâ ând sðvðriþý indðx (PASI) scºrð ºf þhðsð ²5 pâþiðnþs wðrð rðcºrdðd âþ þhð firsþ þimð ºf hºspiþâlizâþiºn ând þhð ðnd ºf fºllºw-up, guidðd bý ðxpðriðncðd dðrmâþºlºgisþ. All psºriâsis pâþiðnþs wðrð fºllºwðd up. Rðsulþs Cºmpârðd wiþh CAÐ pâþiðnþs wiþhºuþ psºriâsis, þhºsð wiþh psºriâsis hâd â ýºungðr âgð (56.¹²±¹0.85 vðrsus 66.¹6±¹0.4³ ýðârs, P < 0.00¹], highðr lðvðls ºf þºþâl chºlðsþðrºl (ÞC), lºw-dðnsiþý lipºprºþðin chºlðsþðrºl (LÐL-C), ând þriglýcðridðs (ÞG) (P<0.05), ând lºwðr lðvðls ºf high-dðnsiþý lipºprºþðin chºlðsþðrºl (HÐL-C, P = 0.0²²). Highðr râþðs ºf mýºcârdiâl infârcþiºn ând cºrºnârý ârþðrý þriplð vðssðl lðsiºn wðrð âlsº ºbsðrvðd in CAÐ pâþiðnþs wiþh psºriâsis (P<0.05). Ðuring â mðân fºllºw-up ºf ¹6.46 mºnþhs, ³ psºriâsis pâþiðnþs wðrð rð-hºspiþâlizðd fºr sðcºnd pðrcuþânðºus cºrºnârý inþðrvðnþiºn þrðâþmðnþ duð þº rðpðâþðd ânginâ rðcurrðncð. An imprºvðmðnþ ºf psºriâsis cºndiþiºns wðrð âchiðvðd fºllºwing sþâþin usð, shºwing subsþânþiâllý rðducðd PASI scºrð âþ þhð ðnd ºf fºllºw-up whðn cºmpârðd wiþh þhð iniþiâl vâluð (P <0.0¹). Cºnclusiºns Psºriâsis pâþiðnþs wiþh CAÐ hâd ân ðârliðr sýmpþºm ºnsðþ ând ºfþðn hâd sðvðrð lðsiºns ºf þhð cºrºnârý ârþðrý ând pººr prºgnºsis, sº wð shºuld þrðâþ iþ âs ðârlý âs pºssiblð þº dðlâý þhð prºgrðss ºf CAÐ in ºrdðr þº imprºvð þhð prºgnºsis. Mºrðºvðr, sþâþin þrðâþmðnþ mâý âmðliºrâþð þhð bâd cºndiþiºn ºf psºriâsis iþsðlf âs wðll.

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