CAJ | 학술논문

男女性别差异对于行急诊经皮冠状动脉成形术治疗患者预后影响分析
남녀성별차이대우행급진경피관상동맥성형술치료환자예후영향분석
Effect of gender difference on the follow-up outcomes for patients undergoing primary PCI

万方数据

中华临床医师杂志（电子版）中華臨床醫師雜誌（電子版） 중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年 11期 1972-1977 ,共6页

何培源%杨跃进%乔树宾%徐波%吴永健%袁晋青%陈珏%刘海波%唐欣然%王杨%李卫%高润霖

하배원%양약진%교수빈%서파%오영건%원진청%진각%류해파%당흔연%왕양%리위%고윤림

血管成形术,经腔,经皮冠状动脉%女(雌)性%治疗结果血管成形術,經腔,經皮冠狀動脈%女(雌)性%治療結果
혈관성형술,경강,경피관상동맥%녀(자)성%치료결과
Angioplasty,transluminal,percutaneous coronary%Female%Treatment outcome

目的：探讨在药物涂层支架时代，行急诊PCI治疗的急性ST段抬高心肌梗死（STEMI）患者中，不同性别患者的PCI预后差异。方法连续纳入687例行急诊PCI治疗的STEMI患者，其中男572例，女115例。比较不同性别患者的基线特征、手术结局及临床预后。结果女性患者发病的平均年龄大于男性，合并多支病变的比例也要高于男性。女性患者院内（3.8%vs.4.3%，P＝0.792）及1年期（6.6%vs.7.8%，P＝0.647）的主要不良心血管事件率与男性无统计学差异。但女性院内的大出血事件（11.3%vs.5.4%，P＝0.019）及穿刺并发症（9.6%vs.4.9%，P＝0.048）要高于男性。女性患者一年随访时的再发心绞痛事件率也要高于男性（10.4%vs.3.9%，P＝0.003）。结论在药物涂层支架时代，对于行急诊PCI治疗的STEMI 患者，不同性别间的近期及1年期的主要临床终点预后相似。但女性的出血及穿刺点并发症风险更高。合理的避免出血是提升女性PCI质量的首要目标。
목적：탐토재약물도층지가시대，행급진PCI치료적급성ST단태고심기경사（STEMI）환자중，불동성별환자적PCI예후차이。방법련속납입687례행급진PCI치료적STEMI환자，기중남572례，녀115례。비교불동성별환자적기선특정、수술결국급림상예후。결과녀성환자발병적평균년령대우남성，합병다지병변적비례야요고우남성。녀성환자원내（3.8%vs.4.3%，P＝0.792）급1년기（6.6%vs.7.8%，P＝0.647）적주요불양심혈관사건솔여남성무통계학차이。단녀성원내적대출혈사건（11.3%vs.5.4%，P＝0.019）급천자병발증（9.6%vs.4.9%，P＝0.048）요고우남성。녀성환자일년수방시적재발심교통사건솔야요고우남성（10.4%vs.3.9%，P＝0.003）。결론재약물도층지가시대，대우행급진PCI치료적STEMI 환자，불동성별간적근기급1년기적주요림상종점예후상사。단녀성적출혈급천자점병발증풍험경고。합리적피면출혈시제승녀성PCI질량적수요목표。
Objective To evaluate the effect of gender difference on the follow-up outcomes for STEMI patients undergoing primary PCI in the era of drug-eluting stents. Methods 687 STEMI patients who have undergone primary PCI were consecutively recruited. The baseline features, procedure outcomes and clinical prognosis were compared between men and women. Results Women were older, and accompanied with a higher rate of multivessel disease. The rates of in-hospital and 1 year major adverse cardiovascular events (MACE) were similar between men and women (3.8%vs. 4.3%, P=0.792, 6.6%vs. 7.8%, P=0.647). Women had higher rates of major bleeding (11.3%vs. 5.4%, P=0.019) and access site complications (9.6%vs. 4.9%, P=0.048) compared with men. The recurrent angina was more frequent in women than in man at 1 year follow-up (10.4% vs. 3.9%, P=0.003). Conclusions There is no gender difference with the short-term or 1 year outcomes for STEMI patients undergoing primary PCI, but women have a higher risk of bleeding and access site complications. To avoid bleeding is the major goal in elevating the PCI quality in women.