中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2012年
11期
897-901
,共5页
孙王乐贤%严健华%赵肖奕%阮燕萍%范中杰
孫王樂賢%嚴健華%趙肖奕%阮燕萍%範中傑
손왕악현%엄건화%조초혁%원연평%범중걸
冠状动脉疾病%女性%危险因素%冠状血管造影术
冠狀動脈疾病%女性%危險因素%冠狀血管造影術
관상동맥질병%녀성%위험인소%관상혈관조영술
Coronary artery disease%Women%Risk factors%Coronary angiography
目的 分析女性急性冠状动脉综合征(ACS)的危险因素和冠状动脉造影特征.方法 2009年3月至2010年8月北京协和医院经冠状动脉造影确诊的冠心病患者1356例,其中ACS 986例,依据性别分为女性组(n=303)和男性组(n=683).收集研究对象的临床和冠状动脉造影资料,用Gensini评分评估冠状动脉狭窄程度.结果 女性60岁前ACS的比率明显低于男性,60岁后超过男性[91.4％ (277/303)比83.5％ (570/683),P＜0.05].女性ACS患者合并高血压或糖尿病的比率高于男性[81.5％ (247/303)比64.0％ (437/536),51.8％ (157/303)比44.0％ (298/683),P均＜0.05];女性冠心病家族史[15.8％ (48/303)比23.0％ (157/683),P＜0.05]和吸烟史较男性发生率低(19.1％比71.7％,P ＜0.001).两组间血脂异常、肥胖、高敏C反应蛋白升高和高纤维蛋白原血症等发生率差异无统计学意义(P均＞0.05).女性ACS组,冠状动脉轻度狭窄病变(50％ ～ 74％)较男性组多见[15.5％(47/303)比10.0％ (68/683),P＜0.05],而严重狭窄及闭塞病变(75％ ～ 100％)较男性组发生率低[84.2％ (255/303)比89.8％ (613/683),P＜0.05];两组间冠状动脉病变支数、病变血管、Gensini总积分及冠状动脉介入治疗率的比较差异均无统计学意义(P＞0.05).结论 女性ACS患者糖尿病和高血压的患病率较高,冠状动脉轻度狭窄多见,严重狭窄和闭塞病变较男性少,临床应结合女性ACS的特点选择合理干预措施.
目的 分析女性急性冠狀動脈綜閤徵(ACS)的危險因素和冠狀動脈造影特徵.方法 2009年3月至2010年8月北京協和醫院經冠狀動脈造影確診的冠心病患者1356例,其中ACS 986例,依據性彆分為女性組(n=303)和男性組(n=683).收集研究對象的臨床和冠狀動脈造影資料,用Gensini評分評估冠狀動脈狹窄程度.結果 女性60歲前ACS的比率明顯低于男性,60歲後超過男性[91.4％ (277/303)比83.5％ (570/683),P＜0.05].女性ACS患者閤併高血壓或糖尿病的比率高于男性[81.5％ (247/303)比64.0％ (437/536),51.8％ (157/303)比44.0％ (298/683),P均＜0.05];女性冠心病傢族史[15.8％ (48/303)比23.0％ (157/683),P＜0.05]和吸煙史較男性髮生率低(19.1％比71.7％,P ＜0.001).兩組間血脂異常、肥胖、高敏C反應蛋白升高和高纖維蛋白原血癥等髮生率差異無統計學意義(P均＞0.05).女性ACS組,冠狀動脈輕度狹窄病變(50％ ～ 74％)較男性組多見[15.5％(47/303)比10.0％ (68/683),P＜0.05],而嚴重狹窄及閉塞病變(75％ ～ 100％)較男性組髮生率低[84.2％ (255/303)比89.8％ (613/683),P＜0.05];兩組間冠狀動脈病變支數、病變血管、Gensini總積分及冠狀動脈介入治療率的比較差異均無統計學意義(P＞0.05).結論 女性ACS患者糖尿病和高血壓的患病率較高,冠狀動脈輕度狹窄多見,嚴重狹窄和閉塞病變較男性少,臨床應結閤女性ACS的特點選擇閤理榦預措施.
목적 분석녀성급성관상동맥종합정(ACS)적위험인소화관상동맥조영특정.방법 2009년3월지2010년8월북경협화의원경관상동맥조영학진적관심병환자1356례,기중ACS 986례,의거성별분위녀성조(n=303)화남성조(n=683).수집연구대상적림상화관상동맥조영자료,용Gensini평분평고관상동맥협착정도.결과 녀성60세전ACS적비솔명현저우남성,60세후초과남성[91.4％ (277/303)비83.5％ (570/683),P＜0.05].녀성ACS환자합병고혈압혹당뇨병적비솔고우남성[81.5％ (247/303)비64.0％ (437/536),51.8％ (157/303)비44.0％ (298/683),P균＜0.05];녀성관심병가족사[15.8％ (48/303)비23.0％ (157/683),P＜0.05]화흡연사교남성발생솔저(19.1％비71.7％,P ＜0.001).량조간혈지이상、비반、고민C반응단백승고화고섬유단백원혈증등발생솔차이무통계학의의(P균＞0.05).녀성ACS조,관상동맥경도협착병변(50％ ～ 74％)교남성조다견[15.5％(47/303)비10.0％ (68/683),P＜0.05],이엄중협착급폐새병변(75％ ～ 100％)교남성조발생솔저[84.2％ (255/303)비89.8％ (613/683),P＜0.05];량조간관상동맥병변지수、병변혈관、Gensini총적분급관상동맥개입치료솔적비교차이균무통계학의의(P＞0.05).결론 녀성ACS환자당뇨병화고혈압적환병솔교고,관상동맥경도협착다견,엄중협착화폐새병변교남성소,림상응결합녀성ACS적특점선택합리간예조시.
Objective To assess the risk factors and coronary angiography characteristics of female patients with acute coronary syndrome (ACS).Methods A total of consecutive 986 inpatients with ACS who had undergone coronary angiography from March 2009 to August 2010 in our hospital were enrolled in this study.There were 303 female patients and 683 male patients.Clinical data were collected by physicians and the severity of coronary artery stenosis was analyzed via the international Gensini Score system.Results Incidence of ACS under the age of 60 years [8.6％ (26/303) vs.16.5％ (113/683),P ＜ 0.05],family history of coronary artery disease [15.8％ (48/303) vs.23.0％ (157/683),P ＜ 0.05],and smokers [19.1％ (58/303) vs.71.7％ (490/683),P ＜0.001] were significantly less while hypertension [81.5％(247/303) vs.64.0％ (437/536),P ＜0.001] and diabetes rate [51.8％ (157/303) vs.44.0％ (298/683),P ＜0.05] were significantly higher in female patients than in male patients.The comorbidities of dyslipidemia,adiposity,hyper-C-reaction protein and hyperfibrinogenemia were similar between male and female patients (P ＞ 0.05).Unstable angina and non-ST-segment elevation myocardial infarction were more often [86.1％ (261/303) vs.78.5％ (536/683)],while ST-segment elevation myocardial infarction was less [13.9％ (42/303) vs.21.5％ (147/683),P =0.005] in female patients than in male patients.There were significantly more incidence of mild coronary artery stenosis [15.0％ (47/303) vs.10.0％ (68/683),P =0.012] and less severely stenotic lesions [84.2％ (255/303) vs.89.8％ (613/683),P =0.013] in female patients than in male patients.Gensini score,percutaneus intervention rate and in-hospital mortality rate were similar between male and female patients with ACS (P ＞ 0.05).Conclusions Prevalence rates of diabetes mellitus and hypertension are higher while positive family history on coronary artery disease and smoking rate are lower in female patients with ACS than in male ACS patients.Female ACS patients are often presented with unstable angina or non-ST-segment elevation myocardial infarction and with mild coronary artery stenosis compared to male ACS patients.
