2008例男女冠心病患者冠状动脉病变与危险因素的临床分析

Comparing coronary artery lesions and risk factors of 2008 male and female coronary heart disease patients by coronary angiography

目的探讨男女冠心病患者冠状动脉病变的差异及其危险因素。方法回顾性分析临床可疑冠心病行冠状动脉造影确诊2008例的病历资料。按性别为2组，男性组1332例，女性组676例，冠状动脉病变程度用病变部位、支数、分型及病变Gensini总积分表示。分析两组患者冠状动脉病变的特点并就高血压、糖尿病、血脂异常和吸烟等危险因素进行比较。结果①男性组单支（26．2％）比例低于女性组（41．7％），而双支病变（33．0％）和三支病变（40．8％）比例均高于女性组（分别为25．9％和32．4％，P〈0．05）。②男性组前降支和右冠状动脉病变发生率（87．5％和67．0％）明显高于女性组（79．6％和54．7％，P〈0．05）。③两组A型病变率最高。女性组A型病变发生率高于男性组，而B型和C型病变分别低于男性组。④女性组高血压和糖尿病高于男性组，吸烟、饮酒和血脂异常低于男性组（P〈0．05）。⑤男性患者Gensini总积分高于女性患者（P=0．000）。结论男性患者以三支病变为主，女性患者以单支病变为主；男性患者冠脉病变程度比女性患者重；女性患者高血压和糖尿病为主要危险因素，男性患者血脂异常、吸烟和饮酒为主要危险因素。

Objective To study difference of coronary artery lesion and risk factors between male and female patients with coronary artery disease. Methods 2008 patients were analyzed retrospectively in our hospital. 1332 male patients were compared with 676 female patients on both coronary pathological changes and risk factors of coronary heart disease. The coronary artery lesion was evaluated by the number, location, type of coronary lesion and Gensini scores. Results （1）Single branch, double branches and three branches lesions in male group male were 26.2%, 33.0% and 40.8% respectively, meanwhile, female group were 41.7% ,25.9% and 32.4% respectively （P〈0.05）. （2）The incidences of left anterior descending branch and right coronary artery lesion in male group （87.5% and 67.0%） were higher than that in female group（79.6% and 54.7%,P〈0.05 ）. （3）A type lestion rate was the highest in two groups, compared with the male group, B type and C type rate in the female group were lower （P〈0.05）. （4）In two group, prevalence rates of hypertension and diabetes in the female group were higher than that in the male group, but prevalence rates of dyslipidemia and smoking and alcohol were exceptionally lower than that in the male group （P〈0.05）. （5）Gensini scores of male group were significantly higher than those of female group （P=0.000）. Conclusion Coronary artery lesion are mainly three-vessel lesions in male group, and single- vessel lesion are common in female group. Hypertension and diabetes are the main risk factors in female group, while dyslipidemia, smoking and alcohol are the main risk factors in male group.