冠状动脉临界病变患者临床特点及病变形态学的性别差异

Gender Differences of Clinical Characteristics and Lesion Morphology in Patients with Borderline Coronary Lesions

目的探讨冠状动脉临界病变患者临床特点及病变形态学的性别差异。方法连续入选北京4家三级教学医院2007年2月至2009年5月期间经冠状动脉造影证实的具有临界病变(狭窄>20%且<70%)患者1920例,分为男性组1281例,女性组639例,入选临界病变2215处,其中男性组1475处,女性组740处,进行QCA分析。结果与男性组相比,女性组年龄较大(65.47±8.60岁比60.30±10.38岁,P<0.001),合并高血压和糖尿病的比例高(分别为74.34%比60.50%,P<0.01;26.45%比22.25%,P<0.05),吸烟、既往心肌梗死史及既往经皮冠状动脉介入治疗术比例低(分别为6.42%比48.95%、4.39%比12.1%及12.21%比18.58%,P<0.01),女性组诊断冠状动脉粥样硬化比例高(40.69%比28.81%,P<0.01),而诊断急性冠状动脉综合征的比例低(40.54%比50.67%,P<0.01),女性组钙化病变比例高(6.36%比4.14%,P<0.05),斑块面积小(7.62±3.22mm2比9.18±4.29mm2,P<0.01),其余病变特征均无统计学意义。结论女性冠状动脉临界病变患者年龄大,合并危险因素多,冠状动脉病变较男性轻,钙化发生率高。

Aim To investigate the gender differences of clinical characteristics and lesion morphology in patients with borderline coronary lesions. Methods From February 2007 to May 2009,1 920 patients from 4 first-class teaching hospital of BeiJINg with borderline coronary lesion （stenosis resulting in 〉20% and 〈70% lumen diameter reduction） confirmed by coronary angiography were enrolled consecutively. A total of 2 215 lesions were analyzed by Quantitative coronary angiography. Results A total of 639 female and 1 281 male were enrolled. Female patients were older than male subjects （65.47±8.60 years old vs 60.30±10.38 years old,P〈0.01）. The incidence of hypertension and diabetes was higher in female group （74.34% vs 60.50%,P0.01; 26.45% vs 22.25%,P〈0.05）,but the incidence of smoking and history of myocardial infarction （MI） and PCI were lower in female group （6.42% vs 48.95%,4.39% vs 12.1%,12.21% vs 18.58%,P〈0.01）. Compared with male subjects,more female patients were diagnosed as coronary atherosclerosis （40.69% vs 28.81%,P〈0.01） and less female patients were diagnosed as acute coronary syndrome （40.54% vs 50.67%,P〈0.01）. Calcification of lesions were more frequent in female cases （6.36% vs 4.14%,P〈0.05） and plaque area was lower than male cases （7.62±3.22 mm2 vs 9.18±4.29 mm2,P〈0.01）. There was no signifi cant difference between genders with regard to other coronary lesion features. Conclusion Female patients with borderline coronary lesions were older than male subjects and had more concomitant diseases. However,female patients had less severe coronary lesions and higher incidence of calcification than male subjects.