性别对急性ST段抬高心肌梗死直接经皮冠状动脉介入治疗预后的影响

Influence of sex on the prognosis of acute ST elevated myocardial infarction after primary percutaneous coronary intervention

目的探讨性别对急性ST段抬高心肌梗死（STEMI）直接经皮冠状动脉介入（PCI）治疗预后的影响。方法分析比较478例男性和101例女性急性ST段抬高心肌梗死患者的危险因素、冠状动脉造影特点和预后情况。结果不同年龄段STEMI发病率的性别差异有统计学意义（P〈0.01），女性发病较男性晚10年以上，≥71岁女性发病率升高更明显；女性多合并原发性高血压、2型糖尿病，且2型糖尿病明显高于男性（P〈0．01）；女性多支病变明显高于男性（P〈0.01）。女性院内病死率、假性动脉瘤／血肿发生率明显高于男性（P〈0.05，P〈0．01）。结论直接PCI治疗STEMI女性患者的住院病死率及穿刺血管并发症发生率较男性高。

Objective To study the influence of sex on the prognosis in acute ST elevated myocardial infarction （STEMI） patients after primary percutaneous coronary intervention （ PCI ）. Methods ： The risk factors, coronary angiography and prognosis in 478 males and 101 females with STEMI were compared. Results ： Mortality of STEMI was significantly different in different age groups （P 〈0.01）. The attack of the STEMI in women was 10 years later than that of men （ P 〈 0.01 ） ,especially in those women whose age was over 71 years old. The complication ratio of hypertension and type 2 mellitus diabetes was higher in female patients than that in male（ P 〈0.01 ）. More multi-vessel lesions were found in female patients than those in male（ P 〈 0.01 ）. The incidence of in-hospital mortality, pseudoaneurysm, haematoma was significantly higher in females than in males （ P 〈 0.05, P 〈 0.01 ）. Conclusions The in-hospital mortality and puncture complications in STEMI female patients treated with primary PCI are higher than male patients.