未绝经女性冠心病患者临床特点分析

Analysis of Clinical Characteristics of Premenopausal Women with Coronary Heart Disease

【目的】分析未绝经女性冠心病患者的临床特点。【方法】对136例女性冠心病患者分为未绝经女性冠心病组（29例）与已绝经女性冠心病组（107例），分析两组患者的冠心病危险因素、临床发病及冠脉造影特点。【结果】未绝经冠心病组高血压、糖尿病、高脂血症的发生率及冠心病传统危险因素个数均显著低于已绝经冠心病组（P〈0．05）；未绝经冠心病组6．9％的患者只合并抑郁；未绝经冠心病组以急性冠脉综合征（ACS）起病比例显著高于已绝经冠心病组（72．4％比30．8％，P〈0．01）；未绝经冠心病组单支病变比例高于已绝经冠心病组（65．5％比28．0％，P〈0．05），且以前降支更容易受累。【结论】未绝经冠心病组冠心病传统危险因素少于已绝经冠心病组，抑郁情绪可能与冠心病的发病有关，多以ACS起病，临床工作中，应注意避免未绝经女性冠心病患者的漏诊。

[Objective] To analyze clinical characteristics of premenopausal women with coronary heart dis- ease（CHD）. [Methods] A total of 136 female patients with CHD were divided into female premenopausal CHD group（ n=29） and female menopausal CHD group（ n = 107）. The risk factor of coronary heart disease, clinical pathogenesis and coronary angiographic characteristics in 2 groups were analyzed. [Results] The inci- dence of hypertension, diabetes mellitus and hyperlipidemia and the common risk factors of CHD in premeno- pausal CAD group were significantly lower than those in menopausal CHD group（ P 〈0.05）. Depression was observed in 6.9% of premenopausal CHD patients. The proportion of acute coronary syndrome（ACS） in pre- menopausal CHD group was significantly higher than that in menopausal CHD group（72.4% vs 30.8%, P〈0.01）. The proportion of single vessel lesion in premenopausal CHD group was higher than that in menopausal CHD group（65.5% vs 28.0%, P d0.05）, and anterior descending branch was easy to be involved in. [Conclusion] The common risk factors of premenopausal CHD group are less than those in menopausal CHD group. Depression mood may be related with the pathogenesis of CHD, and the main onset is ASC. The missed diagnosis of premenopausal CHD patients should be avoided in clinical practice.