青年急性心肌梗死冠脉造影结果性别对比分析

Discussion of the angiographic characteristics of the young patients with acute myocardial infarction in China： a sex-based comparison

目的 探讨青年心肌梗死冠脉血管病变的性别差异.方法 回顾性分析我院2005年1月至2010年12月因急性心肌梗死行选择性冠脉造影的青年患者466例,了解其临床情况并仔细分析其血管病变情况.结果 466例患者根据性别不同分为两组,男性436例,女性30例,两组均以ST段抬高型心肌梗死为主（分别为86.47％和73.33％）,均有较多患者无明显冠脉血管病变（分别为10.55％和20.00％）,但可能因病例数有限,均无明显差异.女性患者左冠优势型明显多于男性（分别为30.00％和10.55％,P＜0.01）,两组冠脉血管起源异常发生率、肌桥发生率无明显差异.两组冠脉血管的钙化、迂曲、偏心、成角、溃疡、撕裂、闭塞、血栓、扩张的发生率无明显差异.但男性患者冠脉岔口病变发生率明显高于女性（分别为61.01％和40.00％,P＜0.05）.结论 青年男女心肌梗死患者血管病变形态有一定的差异,对冠脉病变再血管化治疗方案有一定影响.

Objective To evaluate whether or not the difference of angiographic characteristics of the patients with acute myocardial infarction between young men and young women.Methods Retrospective analysis 466 young acute myocardial infarction patients who were undergone coronary artery angiography consecutively between January 2005 and December 2010.The coronary artery angiographic images were carefully read and the characteristic of each vessel were recorded in details.The interpretation of images was performed visually by two observers blinded to the patients＇ clinical data.Results The study population consisted of 466 young patients （436 men and 30 women） with an age of ＜45 years.They were divided into two groups according to different sex.The rate of hypertension,diabetes and hyperlipidemia was without significant difference in both groups.Most people of both groups were ST segment elevation myocardial infarction（86.47％ vs 73.33％）.A few of patients hadn＇t significant coronary blood vessel disease in both groups （10.55％ vs 20）.00％）.Left coronary artery dominant circulation could be seen more in female than in men （30.00％ vs 10.55％,P＜0.01）.The rate of anomalous origin of the coronary artery and myocardial bridging was without significant difference in both group.The rate of coronary artery calcium,tortuosity,eccentric,angulation,ulceration,laceration,occlusion,thrombus and aneurysmal dilation was without significant difference between both group.The rate of bifurcation lesions was higher in men than in female（61.01％ vs 40.00％,P＜0.05）.Conclusion The angiographic characteristics of coronary artery in young myocardial infarction was different between men and women in a certain extent.This must affected the treatment plan in coronary artery disease revescularization.