CAJ | 학술논문

目的：在已经接受经皮冠状动脉介入治疗（PCI）的冠状动脉粥样硬化性心脏病（冠心病）患者中，了解二级预防治疗现状的性别差异。方法对31家三级甲等医院中至少有一次PCI史的门诊或住院冠心病患者进行病史采集和实验室检查，比较不同性别患者在戒烟、控制体重、血压、血脂以及药物治疗等各方面的差异。结果4532例患者中，女性1151例，占全部PCI患者的25.4%。女性患者有吸烟史的比例明显低于男性患者，但戒烟比例与男性患者差异无统计学意义[52.1%（98例）比51.0%（1344例），P=0.849]。男性患者的平均体重指数、平均腰围和超重比例均大于女性患者（P=0.000），但女性的腰围不达标比例高于男性（59.2%比42.2%，P=0.000）。女性患者合并高血压、高脂血症和糖尿病的比例均高于男性，差异具有统计学意义（P=0.000）。且女性患者血压、血脂和血糖的控制达标比例均低于男性患者，分别为[血压：65.4%比73.1%， P=0.000；低密度脂蛋白胆固醇（LDL-C）：45.2%比54.7%，P=0.000；空腹血糖：52.7%比58.8%， P=0.000]。不同性别患者二级预防药物使用率差异无统计学意义。结论接受PCI的女性冠心病患者合并冠心病危险因素多于男性，而除戒烟和体重控制外，各项危险因素控制达标率均低于男性，女性患者二级预防用药水平与男性相当。
목적：재이경접수경피관상동맥개입치료（PCI）적관상동맥죽양경화성심장병（관심병）환자중，료해이급예방치료현상적성별차이。방법대31가삼급갑등의원중지소유일차PCI사적문진혹주원관심병환자진행병사채집화실험실검사，비교불동성별환자재계연、공제체중、혈압、혈지이급약물치료등각방면적차이。결과4532례환자중，녀성1151례，점전부PCI환자적25.4%。녀성환자유흡연사적비례명현저우남성환자，단계연비례여남성환자차이무통계학의의[52.1%（98례）비51.0%（1344례），P=0.849]。남성환자적평균체중지수、평균요위화초중비례균대우녀성환자（P=0.000），단녀성적요위불체표비례고우남성（59.2%비42.2%，P=0.000）。녀성환자합병고혈압、고지혈증화당뇨병적비례균고우남성，차이구유통계학의의（P=0.000）。차녀성환자혈압、혈지화혈당적공제체표비례균저우남성환자，분별위[혈압：65.4%비73.1%， P=0.000；저밀도지단백담고순（LDL-C）：45.2%비54.7%，P=0.000；공복혈당：52.7%비58.8%， P=0.000]。불동성별환자이급예방약물사용솔차이무통계학의의。결론접수PCI적녀성관심병환자합병관심병위험인소다우남성，이제계연화체중공제외，각항위험인소공제체표솔균저우남성，녀성환자이급예방용약수평여남성상당。
Objective To investigate the gender differences of coronary heart disease secondary prevention status in patients post percutaneous coronary intervention (PCI). Methods Patients diagnosed with coronary heart disease from 31 tertiary hospitals were enrolled for a baseline survey. Medical history and laboratory tests were taken. Analysis was done for outpatient or inpatient with the history of at least one PCI treatment. Status of smoking cessation, weight management, blood pressure < 140/90 mm Hg, low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL (2.6 mmol/L), and use of antiplatlet drugs, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARB) and statins were collected and compared. Results Women (n=1151) accounted for 25.4% of all PCI patients (n=4532). Proportion of female with history of smoking was signiifcantly lower than male, but the proportion of quitting was similar between female and male, 53%(n=98) vs. 53.7%(n=1344), P=0.849. The average body mass index, mean waist circumference and proportion of overweight were higher in man than women, P=0.000. However, the proportion of abdominal obesity in women is higher than men, 75.2%vs. 52.8%, P=0.000. More female were comorbid with hypertension, hyperlipidemia and diabetes than male and the differences were signiifcant, P=0.000. Control rate of blood pressure, LDL-C and fasting glucose were lower in women than in man, the differences were 66.2% vs 73.4% for blood pressure, 47.8%vs. 57.0%for LDL-C and 57.5%vs. 62.7%for fasting glucose, P=0.000. There was no signiifcant difference in medication usage between different genders. Conclusions In patients post pecutaneous coronary intervention, female patients had more risk factors than male while risk factor control rate was lower comparing with male. Medication usage for coronary heart disease secondary prevention was similar between different genders.