摘要
目的探讨绝经前女性冠心病的危险因素和临床特点，为女性冠心病的治疗和预防提供依据。方法连续入选2003～2007年因胸痛入院行冠状动脉造影（冠造）的绝经前女性患者396例。根据冠造结果分为冠心病组185例和对照组211例，回顾分析绝经前女性冠心病的危险因素、临床症状及其冠脉病变特点。结果冠心病组合并原发性高血压94例（50．8％）、2型糖尿病76例（41．1％），同时存在55例（29．7％）。对照组合并原发性高血压46例（21．8％）、糖尿病25例（11．8％），同时存在5例（2．3％）。两组比较差异有显著性（P〈0．05）。冠状动脉CTA检查诊断绝经前女性冠心病的敏感性89．6％、特异性85．7％。41例急性心肌梗死患者有36例（87．8％）发生在月经期的3～7天内O冠造结果提示185例患者中单支病变89例（48．1％），双支病变39例（21．1％），3支病变31例（16．8％）。有138例（74．5％）患者行冠状动脉支架植入术、6例（3．2％）行球囊扩张术、34例（18．3％）患者行冠状动脉搭桥术。结论冠心病的发病率随年龄增加而逐步增加的趋势，而高血压、2型糖尿病是绝经前女性最重要的冠心病危险因素。冠状动脉CTA检查是具有冠心病易患因素的绝经前女性冠心病筛选的重要工具。绝经前女性冠心病的发生、发展与内源性雌激素的变化有关。
Objective To study the clinical characteristics of coronary heart disease （ CHD ） in premenopausal women, and to probe the more prevalent coronary atherogenic risk factors in order to prophylaxis. Methods Three hundred and ninty six premenopausal women with chest pain were divided into 2 groups according to the results of coronary angiography： women with angiographic CHD （n = 185 ） and women with non-CHD as controls （n = 211 ）. The CAD risk factors, clinical symptom and coronary angiography characters were compared. Results Compared with the non-CHD group,the CAD group complicating with hypertensive disease, diabetes mellitus and both are higher. The sensitivity and specificity of 64-slice CT were 89.6% and 85.7% respectively. Thirty-six of the forty-one acute myocardial infarction with regular menstrual cycle occurred during the 3 -7 days after menstrual period; Coronary artery angiography showed one-vessel lesion was 89 （48.1% ） ,double-vessel lesion was 39 （21.1% ）and tri-vessel lesion was 31 （16..8%）. Condusion The morbility of CHD with the age in premenopausal women, often increased with multiple risk factors, the main risk factors of them are hypertensive disease and diabetes mellitus. 64-slice CT is a useful tool for screening CHD in high-risk group. The advancement of CHD are postulated to be related to the fluctuation of estrogen.
出处
《中国医刊》
CAS
2008年第7期22-24,共3页
Chinese Journal of Medicine
