青年女性冠心病患者危险因素及经皮冠状动脉介入术治疗效果分析

The risk factors and the prognosis of PCI treatment in young women with coronary heart disease

目的探讨青年女性冠心病患者的临床危险因素及经皮冠状动脉介入术（PCI）后1年预后分析。方法回顾性分析2009年1月至2012年3月在我院行冠脉造影术明确诊断为冠心病并成功行PCI治疗的青年女性（年龄〈45岁）患者31例（心绞痛18例，急性心肌梗死13例），选取同期住院行冠脉造影检查除外冠心病诊断的青年女性22例为对照组，并选取同期住院诊断为冠心病的青年男性患者52例为性别对照组，选取老年女性冠心病患者50例为年龄对照组。观察高血压史、糖尿病史、早发冠心病家族史、血脂、白细胞、血红蛋白、胆红素、尿酸等与冠心病发病的关系。观察患者冠脉病变特点及PCI治疗效果。结果①与青年女性对照组相比，女性冠心病组合并高血压、糖尿病的比例明显增高（P〈O．05），总胆固醇、极低密度脂蛋白、甘油三酯水平升高，但差异无统计学意义（P〉0．05）。②与性别对照组相比，女性高血压比例高于男性患者（JP〈0．05），而吸烟比例低于男性患者（P〈O．05），两组间平均发病年龄、糖尿病、家族史差异无统计学意义（P〉O．05），女性患者甘油三酯水平高于男性患者（P〈0．05）。③女性患者冠脉造影检查提示单支病变20例，双支病变9例，三支病变2例。所有患者定期随访，无严重出血、心绞痛、再发心肌梗死、心力衰竭、支架内再狭窄及死亡。结论高血压、糖尿病是青年女性冠心病危险因素。青年女性冠心病患者多以单支病变为主，PCI治疗后预后良好。

Objective To observe the risk factors and the prognosis of PCI treatment in young women（ 45 years） with coronary heart disease （CHD）. Methods The risk factors and coronary angiographic features were compared among 31 young women （18 eases with angina, 13 cases with acute myocardial infarction, all the patients underwent treatment of PCI ） and 22 non-CHD young women, 52 young men with CHD were included, all patients were admitted to hospital from January 2009 to March 2012 and underwent coronary angiography. Body mass index, smoking history, familial history of early CHD, essential hypertension, type 2 diabetes mellitus, hyperlipidemia, uric acid, lipids, total bilirubin, direct bilirubin, indirect bilirubin, white blood cells, red blood cells, hemoglobin were measured. The prognosis of PCI treatment after one year in young women with coronary heart disease were observed. Results （1）Prevalence of essential hypertension and type 2 diabetes mellitus were significantly higher in young women with coronary heart disease than in age-matched non-CHD control group （P〈 0.05）. The levels of total cholesterol, very low density lipoprotein, triglyceride were higher in young women with coronary heart disease, but had no statistically significant （P〉0.05）. （2）Prevalence of essential hypertension was significantly higher while smoking history was significantly lower in young women with coronary heart disease than in young men. （3）Coronary angiography revealed single-vessel disease in 20 cases, two-vessel disease in 9 cases and multi-vessel disease in 2 cases. After one year, all the patients had no angina, re-myocardial infarction, heart failure, stent restenosis and death. Conclusion Essential hypertension and type 2 diabetes mellitus were the significantly risk factors of coronary heart disease in young women, single-vessel coronary disease is the most common coronary angiographic features of young women with CHD, and the prognosis of PCI treatment is safe and effective.