目的 探讨不同血型与冠心病风险及冠状动脉病变严重程度的关系.方法 连续入选中国汉族冠状动脉造影确诊的冠心病患者3823例,分为O型血组1140例及非O型血组2683例.进行电话随访,失访169例,完成中位时间24.6个月随访的3654例患者中,发生心血管事件348例(事件组),未发生心血管事件3306例(无事件组),应用Cox比例风险模型评估不同血型患者心血管事件的风险.结果 事件组左主干病变或3支病变比例较无事件组更多(15.2% vs8.1%,47.7% vs 30.5%,P=0.000).与O型血组比较,非O型血组Gensini评分更高(20分vs 18分,P<0.05).非O型血组心血管事件发生率高于O型血组(10.3% vs 7.8%,P=0.019).Cox比例风险模型显示,与O型血组比较,非O型血组更易发生心血管事件(HR=1.318,95%CI:1.030~1.685).调整其他混杂因素后,非O型血是心血管事件再发的独立危险因素(HR=1.291,95%CI:1.008~1.657,P=0.046).结论 中国汉族行冠状动脉造影的人群中非O型血与心血管事件发生相关.
Objective To study the relationship of different ABO blood types with the risk of cardiovascular events and the severity of CHD.Methods A total of coronary arteriography-confirmed 3823 Chinese Han CHD patients were divided into O blood type group (n=1140) and non-O blood type group (n=2683).A total of 3654 patients who were followed up by telephone for a median period of 24.6 months were divided into cardiovascular events group (n=348) and cardiovascular events-free group (n =3306).The risk of cardiovascular events in CHD patients with different ABO blood types was assessed according to the Cox proportional hazards model.Results The incidence of left main branch lesion or 3-branch lesions was significantly higher in cardiovascular events group than in cardiovascular events-free group (15.2% vs 8.1%,47.7% vs 30.5%,P<0.01).The Gensini score was significantly higher in non-O blood type group than in O blood type group (20 vs 18,P<0.05).The incidence of cardiovascular events was higher in non-O blood type group than in O blood type group (10.3% vs 7.8%,P=0.019).Cox proportional hazards model showed that non-O blood type was an risk factor for cardiovascular events (HR =1.318,95 %CI:1.030-1.685).The risk of cardiovascular events was still higher in non-O blood type group than in O blood type group after adjustment for confounders (HR=1.291,95%CI:1.008-1.657,P=0.046).Conclusion Non-O blood type is closely related with cardiovascular events in Chinese Han CHD patients.