冠状动脉造影对女性冠心病的诊断意义

Clinical Diagnosic Problems of the Female Coronary Heart Disease Evaluated by Coronary Artery Angiography

目的：为了解女性冠心病的临床诊断问题，本组回顾性分析５０例女性患者临床诊断冠心病心绞痛行冠状动脉（冠脉）造影检查的临床资料。方法：冠心病组：以冠脉造影血管狭窄≥７５％诊断为冠心病，冠脉狭窄５０％～７５％且临床有心肌缺血证据者也诊断为冠心病，共 ２３例。将冠状动脉狭窄＜ ５％或正常者为非冠心病组，共 ２７例。比较二者有关冠心病危险因素和临床胸痛特点。结果：显示绝经期是女性冠心病特殊危险因素，绝经后冠心病的发生率增加。结论：女性冠心病临床胸痛症状常不典型，绝经后出现典型或不典型胸痛，同时又有明显冠心病危险因素，发生冠心病的可能性较大。绝经后仅有典型或不典型胸痛，而又无明显危险因素，则发生冠心病的可能性较小。

Objective:The clinical date of 50 female cases with suspected coronary heart disease(CHD) undergoing coronary artery an- giography(CAA) were analysed Methods: CHD was defined as an estimated diameter stenosis of 75 % and more in the main coronary arteries or coronary stenosis of 50 % - 75 % with evidence of cardiac ischemia (23 cases). 27 cases were confirmed as non-CHD and served as the control group, including 20 % cases with normal coronary arteries and 7 cases with stenosis of less than 50 % in the right coronary artery or left anterior de- scending artery. Results: The risk factors of CHD and clinical characteristics of chest pain were compared for the two groups.The data demon- strated that menopause was a special risk factor for females and the incidence of CHD was increasing with aging after menopause. Conclusion: The clinical characteristics of chest pain in efrnale CHD were usually atypical. When chest pain, whether clinically typical or atypical, were present after menopause and accompanied by evident risk factors, the probability of CHD would be high, If there was only chest pain without any risk factor for menopause, the diagnosis of CHD would be less likely.