围绝经期冠心病冠脉病变的特殊要点研究

PERIMENOPAUSAL WOMEN WITH CORONARY HEART DISEASE CORONARY PATHOLOGICAL CHANGES THE SPECIAL POINTS OF THE RESEARCH

目的对围绝经期女性冠心病患者冠脉病变特殊要点进行研究和探讨。方法以2011年5月~2013年5月收治的疑似冠心病的221例围绝经期女性患者为研究对象,结合冠脉造影检查结果对患者进行分组,其中冠心病组100例,非冠心病组121例。将冠心病组患者分成绝经前冠心病组44例以及绝经后冠心病组56例。对各组别的冠脉病变情况进行观察和比较。结果绝经期冠心病组的高血压、糖尿病以及高血脂症发病率明显低于绝经后冠心病组,而早发冠心病家族史以及吸烟率明显高于绝经后冠心病组,不稳定心绞痛以及急性心肌梗死率明显高于绝经后冠心病组,双支、三支病变、B型病变以及C型病变的发生率明显低于绝经后冠心病组,经皮冠脉介入治疗或者实施冠状动脉搭桥术率明显较低,采取氯吡格雷、他汀类药物、血管紧张素转化酶抑制剂以及降糖药较低,差异存在统计学意义,p〈0.05。结论绝经前冠心病患者的病变复杂性以及严重性较低,其不稳定心绞痛以及急性心肌梗死的发病率较高,血运重建率较低,药物治疗相比绝经后女性的积极性要低。

Objective Coronary artery lesions in patients with coronary heart disease（ CHD） perimenopausal women special points are studied and discussed. Methods In May 2011 to May 2013 were suspected coronary heart disease（ CHD） of 221 patients with perimenopausal women as the research object,combined with coronary angiography results for grouping patients,with 100 cases of coronary heart disease group,the group of 121 cases of coronary heart disease. Will be divided into premenopausal patients with CHD group of 44 cases of coronary heart disease and coronary heart disease after menopause group 56 cases. Situation for each other of coronary lesions were observed and compared. Results Menopause coronary heart disease group,the incidence of high blood pressure,diabetes and hyperlipidemia was lower than that in group postmenopausal coronary heart disease（ CHD）,and family history of early onset coronary artery disease and smoking rates significantly higher than that of postmenopausal group coronary heart disease,unstable angina and acute myocardial infarction rate is significantly higher than the postmenopausal CHD group,double and three pathological changes,the type B lesion and the incidence of type C lesions was lower than that in group postmenopausal coronary heart disease（ CHD）,percutaneous coronary intervention or implementation was associated with significantly lower rate of coronary artery bypass surgery,take clopidogrel,statins,angiotensin converting enzyme inhibitors,and was lower,the difference is statistically significant,p 0. 05. Conclusion The lesion complexity of premenopausal patients with coronary artery disease and severity is low,the high incidence of unstable angina and acute myocardial infarction,reascularization rates lower,compared to drug therapy in postmenopausal women＇s enthusiasm.