比較的若年者における多枝病変とCoronary Risk Factor

The relationship between the extent of coronary artery disease and correlative risk factors in young men

　近年，我が国における虚血性心疾患の増加が目立つ^1）。従来より冠動脈硬化のRisk Factorとして，高血圧症，肥満，喫煙歴，加齢，性，高血圧，糖尿病，高尿酸血症等が注目されてきたが，その他にも増加の原因として社会の高齢化，種々の社会的ストレスの増加，患者の性格などの関与が考えられている。これらのRisk Factorは年齢によってその重要性が異なり，老年者においては加齢による影響が強くなり，種々のRisk Factorの関与は薄れるとの報告もある^2,3）。したがって加齢による影響が少ない若年者においてこそ，Risk Factorの関与はより大きいと予想される。

　我々は50歳未満の比較的若年者で多枝病変を有する症例のRisk Factorに特有なものがあるか否かを検討した。

To evaluate the relationship between the extent of coronary artery disease (CAD) and correlative risk factors (CRF), 215 patients who underwent the selective coronary arteriographies, were examined five major CRF (hypercholesterolemia, diabetes mellitus (DM), smoking, obesity and hypertension). All patients presented clinically important anginal symptoms. They were devided into the two groups according to whether they were older than 50 years old or not. The patients with multi-vessel disease (VD) had significantly larger number of CRF than single VD only in the younger group ( I VD vs 2VD, p<0.05, 1VD vs 3VD, p<0.01). And only in the younger group, the incidence of hypercholesterole-mia was significanity larger in the patients with multi-VD than single VD (1VD vs 3VD, p<0.05) and total cholesterole of the patients with multi-VD was significantly higher than single VD (1VD ys 2VD, p<0.05, 1VD vs 3VD, p<0.01) and DM might contribute to the occurrence of multi-VD. Smoking also contributed to the occurrence of multi-VD in the both groups.

In conclusion, the number of CRF, hypercholes-terolemia, DM and smoking made a contribution to the multi-VD in the younger group. However, there was not close relationship between CRF and the extent of CAD in the older group.