中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2010年
9期
754-757
,共4页
邵春丽%乔树宾%朱俊%陈珏%杨伟宪%章晏%梁岩%张峻%张文佳
邵春麗%喬樹賓%硃俊%陳玨%楊偉憲%章晏%樑巖%張峻%張文佳
소춘려%교수빈%주준%진각%양위헌%장안%량암%장준%장문가
急性冠状动脉综合征%性别因素%血管成形术,经腔,经皮冠状动脉
急性冠狀動脈綜閤徵%性彆因素%血管成形術,經腔,經皮冠狀動脈
급성관상동맥종합정%성별인소%혈관성형술,경강,경피관상동맥
Acute coronary syndrome%Sex factors%Angioplasty,transluminal,percutaneous coronary
目的 比较不同性别非ST段抬高急性冠状动脉(冠脉)综合征(NSTEACS)患者临床特征和介入治疗对预后的影响.方法 814例NSTEACS患者,随机接受早期(＜24 h)或延迟(＞36 h)介入治疗,随访6个月,主要联合终点为死亡、心肌梗死(MI)和卒中.结果 女性患者年龄较大、更多有高血压、糖尿病、冠心病史和慢性心绞痛史.但入院时心肌标记物升高者较少,现吸烟者少.女性患者冠脉造影非阻塞性病变的比例高,左主干和(或)3支病变的比例与男性相似.经多因素回归分析,既往MI和严重冠脉病变为女性发生主要终点事件的独立预测因素.严重冠脉病变,延迟介入及至少3种冠心病危险因素是男性发生主要终点事件的独立预测因素.结论 不同性别NSTEACS患者影响预后的因素不同,严重冠脉病变为预后的独立预测因素,早期介入治疗有益于降低男性患者180 d心血管病事件风险,但对女性患者预后无影响.
目的 比較不同性彆非ST段抬高急性冠狀動脈(冠脈)綜閤徵(NSTEACS)患者臨床特徵和介入治療對預後的影響.方法 814例NSTEACS患者,隨機接受早期(＜24 h)或延遲(＞36 h)介入治療,隨訪6箇月,主要聯閤終點為死亡、心肌梗死(MI)和卒中.結果 女性患者年齡較大、更多有高血壓、糖尿病、冠心病史和慢性心絞痛史.但入院時心肌標記物升高者較少,現吸煙者少.女性患者冠脈造影非阻塞性病變的比例高,左主榦和(或)3支病變的比例與男性相似.經多因素迴歸分析,既往MI和嚴重冠脈病變為女性髮生主要終點事件的獨立預測因素.嚴重冠脈病變,延遲介入及至少3種冠心病危險因素是男性髮生主要終點事件的獨立預測因素.結論 不同性彆NSTEACS患者影響預後的因素不同,嚴重冠脈病變為預後的獨立預測因素,早期介入治療有益于降低男性患者180 d心血管病事件風險,但對女性患者預後無影響.
목적 비교불동성별비ST단태고급성관상동맥(관맥)종합정(NSTEACS)환자림상특정화개입치료대예후적영향.방법 814례NSTEACS환자,수궤접수조기(＜24 h)혹연지(＞36 h)개입치료,수방6개월,주요연합종점위사망、심기경사(MI)화졸중.결과 녀성환자년령교대、경다유고혈압、당뇨병、관심병사화만성심교통사.단입원시심기표기물승고자교소,현흡연자소.녀성환자관맥조영비조새성병변적비례고,좌주간화(혹)3지병변적비례여남성상사.경다인소회귀분석,기왕MI화엄중관맥병변위녀성발생주요종점사건적독립예측인소.엄중관맥병변,연지개입급지소3충관심병위험인소시남성발생주요종점사건적독립예측인소.결론 불동성별NSTEACS환자영향예후적인소불동,엄중관맥병변위예후적독립예측인소,조기개입치료유익우강저남성환자180 d심혈관병사건풍험,단대녀성환자예후무영향.
Objective To determine gender differences in baseline characteristics and intervention treatment in relation to prognosis in patients with non-ST segment elevation acute coronary syndrome (NSTEACS). Methods A total of 814 patients (545 men and 269 women) with NSTEACS were randomized to early intervention (coronary angiography ＜ 24 hours after randomization ) or delayed intervention (coronary angiography＞36 hours after randomization). The primary outcome was a composite of death, myocardial infarction, or stroke at 6 months. Results Women were older and more frequently had hypertension, diabtetes, and history of coronary artery disease (CAD) or chronic angina (P＜0.05 for all).Women less were smokers and had elevations in cardiac marker(P ＜ 0. 05 for both). Women who underwent angiography had no significant lesions more often, but the left main stem and/or three-vessel diseases were similar with men. In adjusted multiple logistic regression analysis,the previous myocardial infarction and severe coronary artery disease were independently associated with the risk of primary endpoint in women. On multivariate analysis for men, severe coronary artery disease delayed intervention strategy and at least 3 risk factors for CAD were independently associated with the risk of primary endpoint. Conclusions In NSTEACS patients, different gender had the different prognostic predictor. Severe coronary diseases were as an independent predictor for both male and female patients. An early intervention strategy resulted in a beneficial effect in men which was not seen in women.
