绝经期前女性冠心病患者冠脉病变特点及其危险因素分析

Characteristics and risk factors of coronary artery lesions in premenopausal female patients with coronary heart disease

目的:观察绝经期前女性冠心病(CHD)患者冠状动脉病变特点及其危险因素。方法:入选绝经期前女性冠心病患者102例作为观察组,平均(48.2±7.5)岁,同时入选同年龄段CHD男性及非CHD女性患者各100例作为对照组,所有患者均行常规生化,心电图,超声心动图以及冠状动脉造影检查。结果:与CHD男性患者比较,绝经期前CHD女性有糖尿病史者比例明显升高(18.0%比27.5%),而吸烟者(31.0%比12.7%)、患ST段抬高心肌梗死比例(15.0%比2.9%)明显减小,左室射血分数(LVEF)明显降低[(59.7±9.8)%比(52.8±8.5)%],C型病变(32.0%比56.9%),Gensini积分≥40的病例(32.0%比44.1%)明显增多,P均<0.05。与非CHD女性相比,高血压(32.0%比52.9%),糖尿病患病率(9.0%比27.5%)及C反应蛋白水平[(11.35±8.35)mg/L比(16.40±6.49)mg/L]明显升高,LVEF[(59.9±5.3)%比(52.8±8.5)%]显著降低,P均<0.05。结论:绝经期前女性冠心病患者冠状动脉病变较重,临床风险较高。

Objective：To observe characteristics of coronary artery lesions and its risk factors in premenopausal female patients with coronary heart disease（CHD）.Methods：A total of 102 premenopausal female CHD patients were enrolled as observation group and their mean age was（48.2±7.5） years old.Another 100 male CHD patients and 100 female non-CHD patients with same age were regard as control groups.All patients underwent routine biochemical examinations,echocardiography and coronary angiography examinations.Results：Compared with male CHD patients,there were significant increase in ratio of diabetes mellitus（18.0% vs.27.5%）,C type lesions（32.0% vs.56.9%） and ratio of cases with Gensini scores ≥40（32.0% vs.44.1%）,and significant decrease in ratios of smokers（31.0% vs.12.7%） and patients with ST segment elevation myocardial infarction（15.0% vs.2.9%）,and left ventricular ejection fraction in premenopausal female CHD patients,P〈0.05 all.Compared with female non-CHD patients,there were significant increase in incidence rates of hypertension（32.0% vs.52.9%） and diabetes mellitus（9.0% vs.27.5%） and level of C-reactive protein [（11.35±8.35） mg/L vs.（16.40±6.49） mg/L],and significant decrease in LVEF[（59.9±5.3）% vs.（52.8±8.5）%]in premenopausal female CHD patients,P〈0.05 all.Conclusion：Coronary artery lesions are more severe and clinical risk is higher in premenopausal female patients with coronary heart disease.