绝经前女性冠心病患者临床危险因素分析

Clinical analysis of the risk factors in premenopausal women with coronary heart disease

目的探讨绝经前女性冠心病患者临床危险因素的特点。方法选择2010年10月至2012年10月已拟诊冠心病住院的绝经前女性患者140例，根据冠脉造影检查分为冠心病组（90例）和对照组（50例），对140例患者均抽血检测总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、尿酸、C-反应蛋白、同型半胱氨酸，并详细询问患者的年龄、身高、体质量、冠心病家族史、吸烟史、高血压史及糖尿病史。结果冠心病组中高血压史、糖尿病史、体质量指数、三酰甘油、C-反应蛋白、同型半胱氨酸均高于正常对照组，高密度脂蛋白胆固醇低于对照组；糖尿病史、高血压史、三酰甘油、同型半胱氨酸、C-反应蛋白为绝经前女性冠心病的独立危险因素，而高密度脂蛋白胆固醇为绝经前女性冠心病的保护因素。冠心病组同型半胱氨酸与三酰甘油和C-反应蛋白呈正相关，与高密度脂蛋白胆固醇呈负相关。结论高血压、糖尿病、三酰甘油、同型半胱氨酸、C-反应蛋白为绝经前女性冠心病患者的独立危险因素。同型半胱氨酸与绝经前女性冠心病患者其他危险因素可能具有协同作用，共同促进绝经前女性冠心病的发生、发展。

Objective To investigate the clinical features of the risk factors of premenopausal women with coronary heart disease（CHD）. Methods From October 2010 to October 2012, 140 premenopausal women patients diagnosed as coronary heart disease were included. According to the coronary angiography（CAG） result, all patients were divided into CHD group （90 patients）and control group （50patients）. All of the 140 cases were determinated the level of TC, TG, HDL-C, LDL-C, UA, CRP and HCY. Age, weight, family history of coronary heart disease, smoking history, hypertension history and diabetes history being asked in details. Results Compared with the control group, there were significant higher proportion of hypertension, diabetes, BMI and increased TG, CRP, HCY levels and decreased HDL-C level in CHD group. Multivariate Logistic regression analysis showed hypertension, diabetes, TG, CRP, HCY, and decreased I-IDL-C were independent risk factors for CHD group patients. The HCY level of CHD group were positively correlated with the level of TG and CRP, and negatively correlated with the level of HDL-C. Conclusions The study suggests that TG, hypertension, diabetes, CRP, HCY and lower HDL-C levels were independent risk factors for premenopausal women with coronary heart disease. HCY may have a synergistic effect with other risk factors.