中青年女性冠心病患者冠状动脉介入治疗的研究

Clinical study of coronary intervention on middle-aged women with coronary heart disease

目的总结分析(中青年)50岁以下进行冠状动脉介入治疗的女性和男性冠心病患者的临床特点及近远期临床疗效。方法选择2001年11月—2007年12月择期接受冠状动脉介入治疗的50岁以下所有未绝经的186例女性患者作为女性组,选择同期所有行冠状动脉介入治疗的50岁以下男性患者215例作为对照(男性组)。两组均在术后半年行临床冠状动脉造影随访,所有患者均临床随访一年。结果共入选186例女性患者240处病变,215例男性患者332处病变,两组均完成随访。女性组的血脂异常、陈旧性心肌梗死及吸烟史比例均低于男性组。左主干病变比例女性组高于男性组(11.3%比3.0%,P﹤0.01)。左前降支比例女性组高于男性组(61.3%比47.0%P﹦0.001)。右冠状动脉病变比例女性组低于男性组(16.3%比34.0%,P﹤0.001)。C型病变比例女性组低于男性组(36.3%比48.8%,P﹦0.008)。分叉病变比例女性组高于男性组(32.5%比11.1%,P﹤0.001)。住院期及1年随访期间,女性组与男性组主要不良心血管事件、血栓发生率及再狭窄率差异无统计学意义。结论病变位于左主干、前降支和分叉病变的比例50岁以下女性冠心病患者高于50岁以下男性冠心病患者,但是男性患者的冠心病危险因素较多、冠状动脉病变较严重。50岁以下男、女冠心病患者冠状动脉介入治疗的近远期疗效无显著性差异。

Objective To analyze the clinical characteristics and clinical outcomes in young（≤50 years） female and male coronary artery disease（CAD） patients undergoing percutaneous coronary intervention（PCI）.Methods Angiographic and clinical data from 186 premenopausal female patients who underwent elective PIC betwen 2001 and 2007 in our department.All patients were treated according to guidelines and coronary angiography was repeated after 6 months.One year clinical follow-up were performed in all patients.Results Incidences of dyslipidenia,the history of myocardial infarction and smoking were signficantly lower in female patients than in male patients（all P0.01）.Left main,left anterior descending and bifurcation lesions were more common while type C lesion and right coronary lesion were less common in young female CAD group compared to young male CAD group（P0.01）.The in-hospital and follow-up incidences cardiac events,stent thrombosis and in-stent restenosis were similar between young femaie and male CAD patients.Conclusions CAD risk factors were less and vessel lesions were more likely to be found at left main,left anterrior descending and bifurcation in young female CAD patients compared to young male CAD patients.The clinical outcomes were similar between young female and male CAD patients.