绝经后女性冠状动脉慢血流现象的相关因素分析

Correlation factors of slow coronary flow phenomenon in postmenopausal females

目的探讨可能与绝经后女性冠状动脉慢血流（slow coronary flow，SCF）现象相关的危险因素。方法回顾性分析2005年8月至2010年12月在新疆医科大学第一附属医院心脏中心行冠状动脉造影，显示心外膜主要冠状动脉无明显病变的患者186例，其中绝经后女性52例的临床资料。把冠状动脉血流仅为心肌梗死溶栓试验（thrombolysis in myocalrdial infarction，TIMI）血流2级或以下的患者定义为SCF。将绝经后女性患者分为绝经后女性SCF组（n=24）和绝经后女性对照组（n=28）。结果绝经后女性SCF组与绝经后女性对照组年龄、原发性高血压和糖尿病所占比例、血小板计数和血清空腹血糖、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血尿酸浓度比较，差异无统计学意义（P〉0．05）；而绝经后女性SCF组的自细胞计数[（6．279±1．828）×10^9/Lvs.（5．241±1．527）×10^9g／L，P〈0．05]、中性粒细胞计数[（6．688±1．705）×10^9／Lvs.（3．763±1．573）×10^9／L，P〈0．05]、左心室质量指数（left ventricular mass index，LVMI）[（110．530±30．936）g／m^2 vs.（93．815±20．141）g／m^2，P〈0．05]均高于对照组，差异有统计学意义。Logistic分析表明，绝经女性SCF与LVMI（OR=1．028，95％CI：1．002-1．055，P=0．037）、白细胞计数（OR=1．501，95％CI：0．011-2．229，P=0．044）相关。结论白细胞计数、中性粒细胞计数、LVMI增高可能参与了绝经女性SCF的发生、发展。LVMI、白细胞计数增高可能是绝经女性SCF患者的危险因素。

Objectives To analyze the correlation factors of slow coronary flow （SCF） phenomenon in postmenopausal women retrospectively. Methods There were 186 cases with angiographically proven normal coronary arteries admitted during August 2005 to December 2010 in The First Affiliated Hospital of Xinjiang Medical University. Of all the cases, data of 52 postmenopausal females were included in this study. Coronary flow patterns of these cases were determined by thrombolysis in myocardial infarction （TIMI） method. Patients with TIMI 2 or less were included in postmenopausal female SCF group （n=24） and the others were included in control group （n=28）. Results There were no statistical differences between the two groups in respect to age, history of hypertension, diabetes mellitus, platelet count, hemoglobin level, fasting plasma glucose, triglyceride, total cholesterol, low-density lipoprotein-cholesterol level, high-density lipoprotein-cbolesterol level and blood uric acid level （P〉0.05）. However, white blood cell count, neutrophil count, left ventricular mass index （LVMI） were significantly higher in SCF group compared with those in control group [ （6.279± 1.828）×10^9/L vs. （5.241±1.527） ×10^9/L, P〈0.05; （6.688±1.705） ×10^9/L vs. （3.763±1.573） ×10^9/L, P〈0.05; （110.530±30.936） g/m^2 vs. （ 93.815±20.141 ） g/m^2, P〈0.05 ]. Logistic regression indicated that LVMI, white blood cell were the risk factors of SCF phenomenon in postmenopausal women （OR=1.028, 95%CI： 1.002-1.055, P=0.037 ; OR= 1.501, 95% CI： 0.011-2.229, P=0.044）. Conclusions Increase of white blood cell count, neutrophil count and LVMI may play a role in the pathogenesis of SCF phenomenon in postmenopausal females. Increase of LVMI and white blood cell count can be the risk factors of SCF phenomenon in postmenopausal females.