女性急性心肌梗死的临床特点和预后危险因素分析

Clinical features and prognostic risk factor analysis for female patients with acute myocardial infarction

目的：分析女性急性心肌梗死（AMI）的临床特点和预后危险因素。方法：选择2011年8月到2014年10月期间我院收治的97例女性AMI患者作为研究对象（女性组），同时选择120例男性AMI患者作为对照（男性组），所有患者自入院起接受3个月的随访。比较两组患者的基线资料，临床特点和预后，同时分析女性患者的预后危险因素。结果：与男性组比较，女性组年龄，心脑血管病，糖尿病和高血脂比例均显著升高，红细胞计数，血红蛋白水平，烟酒史和消化、泌尿系统疾病比例均显著降低（P〈0．05或〈0．01）。与男性组比较，女性组心功能Ⅳ级（14．17％比24．74％），冠脉3支病变比例（3．33％比12．37％）及再灌注治疗率（51．67％比73．20％）显著升高（P均〈0．05）。女性组的死亡率（9．28％比2．50％）和并发症发生率（31．96％比19．17％）均显著高于男性组（P均〈0．05）。Logistic回归分析显示：患者的年龄，既往心脑血管病，糖尿病，高血脂，Killip心功能分级和病变血管支数与预后显著相关（OR=0．176～4．931，P均〈0．05）。结论：女性AMI患者的预后较男性差，患者的预后与年龄，心脑血管疾病，糖尿病，高血脂，心功能分级和病变血管支数相关。

Objective： To analyze the clinical features and prognostic risk factors of female patients with acute myo- cardial infarction （AMI）. Methods： From Apr 2011 to Oct 2014, a total of 97 female AMI patients treated in our hospital were enrolled as female group, meanwhile 120 male AMI patients were regarded as control group （male group）. All patients received three-month follow-up after hospitalization. Baseline data, clinical features and prog- nosis were compared between two groups, and prognostic risk factors of female patients were analyzed at the same time. Results： Compared with male group, there were significant rise in percentages of cardio- and cerebrovascular diseases, diabetes mellitus and hyperlipidemia, and significant reductions in red blood cell count, hemoglobin level, and percentages of smoking ＆ drinking history, digestive ＆ urinary system diseases in female group, P〈0.05 or 〈 0.01. Compared with male group, there were significant rise in percentages of Killip class 1V （14. 17% vs. 24.74%）, three-vessel coronary disease （3.33% vs. 12.37%）, therapeutic rate of reperfusion （51.67% vs. 73.20%）, mortality （2.50% vs. 9.28%） and incidence of complications （19.17% vs. 31.96%） in female group, P 〈0. 05 all. Logistic analysis of regression showed that age, previous cardio- and cerebrovaseular diseases, diabetes mellitus, hyperlipidemia, Killip cardiac function class and number of diseased coronary vessels were significantly cor- related with prognosis （OR = 0. 176~4. 931, P〈0.05 all）. Conclusion： Prognosis of female AMI patients is poorer than that of males. Prognosis is related to age, cardio- and cerebrovascular diseases, diabetes mellitus, hyperlipi- demia, Killip cardiac function class, and number of diseased coronary vessels .