CAJ | 학술논문

目的分析不同性别冠心病(CHD)患者危险因素及其冠状动脉(冠脉)病变的特点.方法纳入2009年1月至2011年1月在解放军总医院经冠脉造影确诊为CHD患者共3765例(男性2661例,女性1104例),收集患者各类临床资料及冠脉病变数据.根据患者年龄和性别进行分层,应用logistic回归模型分析CHD传统危险因素及冠脉病变的特点.结果 (1)女性发病年龄迟于男性,且合并CHD传统危险因素多；女性随年龄增长,吸烟的比例下降,血脂异常和糖尿病的比例显著升高.男性患者中,吸烟是最常见的危险因素.(2)性别间比较的logistic回归模型提示,糖尿病可显著增加女性罹患CHD的风险(OR=2.05,95％CI:1.49～ 2.81,P＜0.001),而吸烟则可明显增加男性罹患CHD的风险(OR=9.27,95％CI:7.68～11.19,P＜0.001).(3)随着年龄增长,女性患者冠脉病变支数增加,血管狭窄程度加重；而男性冠脉病变程度无随年龄增长而变化的趋势.结论不同性别的CHD患者在不同年龄段具有不同的危险因素和冠脉病变特点.糖尿病和血脂异常似对女性冠脉病变的影响较大,而吸烟则对男性影响较大.
목적 분석불동성별관심병(CHD)환자위험인소급기관상동맥(관맥)병변적특점.방법 납입2009년1월지2011년1월재해방군총의원경관맥조영학진위CHD환자공3765례(남성2661례,녀성1104례),수집환자각류림상자료급관맥병변수거.근거환자년령화성별진행분층,응용logistic회귀모형분석CHD전통위험인소급관맥병변적특점.결과 (1)녀성발병년령지우남성,차합병CHD전통위험인소다；녀성수년령증장,흡연적비례하강,혈지이상화당뇨병적비례현저승고.남성환자중,흡연시최상견적위험인소.(2)성별간비교적logistic회귀모형제시,당뇨병가현저증가녀성리환CHD적풍험(OR=2.05,95％CI:1.49～ 2.81,P＜0.001),이흡연칙가명현증가남성리환CHD적풍험(OR=9.27,95％CI:7.68～11.19,P＜0.001).(3)수착년령증장,녀성환자관맥병변지수증가,혈관협착정도가중；이남성관맥병변정도무수년령증장이변화적추세.결론 불동성별적CHD환자재불동년령단구유불동적위험인소화관맥병변특점.당뇨병화혈지이상사대녀성관맥병변적영향교대,이흡연칙대남성영향교대.
Objective This study aimed to determine the prevalence rates of conventional risk factors and to analyze the features of coronary lesions in patients with coronary heart disease (CHD).Methods 3765 CHD cases were collected from the General Hospital of PLA in Beijing from 2009 to 2010 (2661 men,1104 women).All the CHD patients enrolled in our study were diagnosed through angiography.Clinical and angiographic data of CHD patients were collected.After stratification on age and sex of the patients,logistic analysis method was used to evaluate the prevalence rates on conventional risk factors and to analyze the features of coronary lesions on CHD.Results ( 1 ) More than two risk factors and advancing age of onset were commonly seen in female CHD patients.In those premature female CHD patients (age ＜45 years),there was a high proportion the habit of smoking.With the increase of age,proportions of patients with diabetes mellitus and hyperlipidemia also significantly increased.For male patients at different age,the proportions of smoking were high.(2) Data from logistic analysis suggested that diabetes mellitus could increase the prevalence of CHD on women (OR=2.05,95％CI:1.49-2.81,P＜0.001),and smoking was a risk factor for men (OR=9.27,95％CI:7.68-11.19,P＜0.001).(3) Along with the increase of age,female patients appeared to have more coronary vessel injures or severe coronary artery lesions.Different from the females,there was no change could seen on the characteristics of coronary lesions at different age for males.Conclusion Prevalence rates on risk factors and the characteristics of coronary lesions appeared to be different with age.Diabetes mellitus and hyperlipidemia seemed to impact more on women while smoking seemed to impact more on men.