急性冠脉综合征的临床性别差异性分析

Clinical Analysis of Sex Difference in ACS

目的:探讨急性冠脉综合征(ACS)患者主要诊断和治疗的性别差异性。方法:对569例ACS患者的临床资料进行男女分组对比分析。结果:男性组吸烟者多,女性组高龄、合并高血压、糖尿病者显著。男女两组在单支病变(30.8％比34.3％),双支病变(32.2％比28.7％),三支病变(37.1％比37.1％),左前降支(LAD)病变(85.7％比89.5％),回旋支(LCX)病变(58.9％比59.4％),右冠状动脉(RCA)病变(61.5％比55.2％)及左主干(LM)病变(9.6％比5.6％)方面差异无显著性(P均>0.05),随后的血管成形术(PTCA)的病例数两组也无显著差异,但男性组冠状动脉旁路移植术(CABG)的比例偏高(30.3％比19.6％,P<0.05)。6个月随访两组在心血管死亡、心肌梗死和血管重建治疗方面未见显著差异。结论:男女ACS患者在主要诊断和治疗原则上相似,经冠状动脉造影后,选择合适的病人实施积极的血管重建,获益无性别差异。

Objective: To investigate the sex differences of the patients with ACS in diagnosis and treatment. Methods: 569 patients with ACS were divided into two groups according to male or female and were comparatively analysed. Resuets: Compared with female group, more smoker and lower percentage of patient with high age and hypertension presented in male group. There were no significant differences in single vessels disease (30.8% vs 34.3%) , double vessel lesion (32.2% vs 28.7%), triple vessel disease (37.1% vs 37.1%), LAD lesion (85.7% vs 89.5%), LCX (58.9% vs 59.4%), RCA (61.5% vs 55.2%), LM (9.6% vs 5.6%) between the male and female group(all P > 0.05) .The percentage of patients underwent PTCA was similar in the 2 group (P > 0.05), but the number of patients underwent CABG increastd in male group(P < 0.05) . The results at 6 months follow - up showed there were no significant differences in incidence of cardiac death, non - fatal myocardial infarcfion and target vessvel revusco-lence of cardiac death, non- fatal myocardial infevrction and target vessel revascularization in the 2 groups (all P > 0.05). Conclusions: there were no sex differences in chief diagnosis and treatments and benefiting from agressive revescularization regimen.