小于40岁青年女性冠状动脉疾病病因及临床特点的研究

Etiology and clinical characterization of coronary artery disease in young female less than forty years old

目的:本文通过对年龄<40岁的青年女性冠心病患者的易患因素,冠状动脉造影特点及血运重建进行回顾性研究,进而对病因及临床特点进行探讨。方法:本研究采用回顾性的方式,入选2005年1月至2011年12月入院,年龄为20～40岁,冠状动脉造影证实冠心病的107例青年女性患者,对其冠心病易患因素,冠状动脉造影特点,血运重建治疗特点进行研究,并与同时期住院的20～40岁的320名青年男性患者进行对比。结果:患者平均年龄(37.53±3.11)岁。其中急性心肌梗死占20.6%,最常见的冠心病易患因素为高血压(51.4%),其次为高脂血症(40.2%),糖尿病患者占20.8%。冠状动脉造影示病变以单支病变为主占59.4%。绝大多数合并前降支病变(81.1%)。左主干病变占12.3%,3支病变为9.3%。糖尿病或合并有2种以上易患因素者患多支病变的比例明显增加。71.7%的患者接受PCI治疗,平均置入(1.4±1.1)枚支架,17.9%的患者接受外科手术治疗。13例可能为非传统易患因素所致冠状动脉疾病,其中多发性大动脉炎4例,系统性红斑狼疮2例,1例患者为川崎病,1例患者为马方综合征出现主动脉夹层累及右冠状动脉,2例为产后自发性冠状动脉夹层。结论:青年女性冠心病患者易患因素及临床表现有其特殊性,需要建立多中心的大样本研究以增进青年女性冠心病病因及临床特点的理解。

Objective：To identify the etiology and clinical characters of coronary artery disease in female patients less than 40 years old.Methods： From January 2005 to Dec.2011,107 female patients less than 40 years old with coronary artery disease proved by coronary angiography were studied.Results： Mean age of patients was（37.57±3.11）years old.20.6% of patients presented with acute myocardial infarction.51.4%of patients had risk factor of hypertension.20.8% had diabetes,40.2% of patient had hyperlipidemia.59.4% were single vessel disease.and 9.3% were three vessel disease.The lesion located at left descending artery was 81.1%,followed by Left circumflex artery 33% right coronary artery 28.3% and left main 12.3%.71.7% of patients had stents implantation.18% of patients received CABG.Among those patients who were lack of traditional risk factors,3 had arteritis,2 were systemic lupus erythematosus,1 had Kawasaki disease,1 had Marfan syndrome complicated with arotic artery and coronary dissection and spontaneous coronary artery dissection post partum.Conclusion：The etiology,risk factors and clinical characteristics of coronary artery disease in female patient less than forty years old are different,non-traditional etiology need to be identified and worth further investigation.