绝经前冠心病临床特征分析

Analysis of Clinical Features of Premenstrual Women with Coronary Heart Disease

目的探讨绝经前冠心病的危险因素、临床特点及冠状动脉(冠脉)造影结果,为临床正确诊断提供依据。方法选择绝经前疑诊冠心病213例行冠脉造影检查,按冠脉造影结果分组,冠脉狭窄≥50%为造影阳性组,冠脉正常或狭窄<50%为造影阴性组,比较两组发病危险因素和临床特征。结果造影阳性组96例,其中单支病变62例(64.6%),双支病变23例(24.0%),三支病变11例(11.5%);前降支病变58例(60.4%);阴性组117例。两组年龄及糖尿病、高血压病发病率比较差异有统计学意义(P<0.05),而在吸烟史、冠心病家族史、高脂血症、肥胖等方面比较差异无统计学意义(P>0.05)。两组收缩压、血糖、典型心绞痛症状、急性冠脉综合征、特异性心电图等方面比较差异有统计学意义(P<0.05);体重指数、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血清总胆固醇及纤维蛋白原等方面比较差异无统计学意义(P>0.05)。结论年龄、高血压、糖尿病为绝经前女性冠心病重要危险因素,对于临床症状不典型、心电图阳性率较低的绝经前疑诊冠心病患者,可及时行相关检查,以尽早明确诊断。

Objective To investigate the risk factors, clinical features and coronary angiography results of premenstrual women with coronary heart disease（CHD）. Methods 213 premenstrual women suspected of having CHD, undertook coronary angiography. According to the results of coronary angiography they were divided into coronary stenosis （ 〉150% diameter reduction） as coronary angiography positive group, and 〈50% diameter reduction or normal coronary artery as coronary angiography negative group. The risk factors, clinical symptoms and the coronary angiographic characteristics between the two groups were compared. Results There were 96 cases with coronary angiography positive, coronary lesion involved a single vessel in 64.6% （62/96）, two vessels in 24.0% （ 12/96）, and three vessels in 11.5% （11/96）. 58 cases were with left anteri- or descending branch. The other 117 cases were with coronary angiography negative. There were statistically significant differences between the two groups in age, incidence rate of diabetes and hypertension （P 〈 0. 05）, but no significant differences were found in smoking history, CHD family history, hyperlipidemia, adipositas （P 〉 0. 05）. The difference was statistically significant in the two groups in contractive pressure, blood glucose, typical angina pectoris, acute coronary syndrome and typical change of ECG（P 〈 0. 05）. Conversely, there was no difference in BMI, Triglyceride, LDL-C, HDL-C, TD and fibrinogen of the two groups （P 〉 0. 05）. Conclusion Age, hypertension and diabetes are major risk factors in premenstrual women with CHD. Premenstrual women who were suspected of having CHD with uncharacteristic clinical symptoms, low ECG positive rate, should undertake coherence checks for final diagnosis.