45岁以下青年女性冠心病患者的临床和冠状动脉病变特点

Study on clinical and coronary angiographic profile in female patients aged below 45 with coronary heart disease

目的:回顾分析45岁以下女性冠心病(CHD)的临床和冠状动脉病变特点。方法:收集2000年1月～2008年12月住院行冠状动脉造影证实为CHD的45岁以下女性和男性患者的临床资料、冠状动脉病变特点,检测血脂、纤维蛋白原、血尿酸等水平,进行分析比较。结果:青年女性CHD患者较同龄男性患者CHD家族史、高血压病、糖尿病、高密度脂蛋白胆固醇(HDL-C)、CRP水平显著升高,但血尿酸水平显著降低。冠状动脉造影显示病变类型以局限和节段病变为主,单支病变约61%,罪犯血管左前降支病变占43%以上。青年女性典型心绞痛者占69%,急性心肌梗死所占的比例也较低(7%),与男性比较差异显著(P<0.05),胸痛时心电图ST-T特异性改变占59%(P<0.05)。结论:45岁以下女性CHD患者并发高血压病、糖尿病、CHD家族史、HDL-C和CRP的比例较高,但血尿酸水平显著降低。

AIM： To investigate the clinical and coronary angiographic profile and C-reactive protein （CRP） and their relation with coronary heart disease （CHD） in female patients aged below 45. METHODS： Ninety-two female inpatients （ aged ≤ 45 years ） with confirmed CHD by coronary angiography in our hospital from January 2000 to January 2008 were included in the study, and their clinical and coronary angiographie characteristics were investigated retrospectively. RESULTS ： Significant difference of hyper- tension, diabetesmellitus, hyperlipidemia, CRP and HDL-C was found in the patients under study（P 〈 0.05 ）. The CHD family history ratio in the female patients was significantly higher than that in male counterparts, and their blood uric acid ratio was significantly lower than that in male counterparts （both, P 〈 0. 05）. In the female patients, the single lesion accounted for 61% , the left anterior descending branch of culprit and calcified vessels for 43% , the unstable angina pectoris for 69% and the acute cardiac infarction for 7%. The levels of CRP were positively correlated to the number of lesions of coro- nary artery disease. CONCLUSION： Female CHD patients aged below 45 have higher risk factors to be complicated by hypertension, diabetes, HDL-C, CRP and hyperlipidemia but have lower ratios of blood uric acid. The increase of the level of CRP could be an independent risk factor to predict CHD in female patients.