女性早发冠心病病人冠状动脉病变特点及危险因素分析

Characteristics of Coronary Artery Lesions and Risk Factors in Female Patients with Premature Coronary Artery Disease

目的探讨女性早发冠心病病人冠状动脉病变特点及其危险因素。方法入选我院2012年6月—2015年4月经冠状动脉造影诊断为冠心病的女性病人300例,根据年龄≤55岁为早发组与非早发组。统计病人入院基本临床资料,比较两组病人冠状动脉病变的特点,并运用多因素Logistic回归分析探讨女性早发冠心病病人危险因素。结果与女性非早发组相比,女性早发组主要临床表现为急性冠脉综合征（69.6%vs 25.3%,P〈0.05）,早发组病人吸烟、高脂血症、早发冠心病家族史比例更高,两组之间比较有统计学意义（P〈0.05）,血浆纤维蛋白原（Fg）、三酰甘油（TG）水平均显著高于非早发组,两组之间有统计学意义（P〈0.05）;就冠状动脉病变特征而言,与非女性早发组相比,女性早发组病人冠状动脉病变以单支病变为主（58.7%vs30.7%,P〈0.05）,二者在病变部位上无差别;女性早发组平均冠状动脉病变支数、平均Gensini积分均低于非早发组（1.86±0.73 vs2.73±0.88,P〈0.05;10.47±2.56 vs53.82±14.02,P〈0.05）;多因素Logistic回归分析显示吸烟（OR=9.5 3 2,9 5%CI：8.2 3 5~22.053,P=0.000）、早发冠心病家族史（OR=11.734,95%CI：6.362~21.523,P=0.001）、Fg（OR=5.146,95%CI：3.804~17.186,P=0.002）、TG（OR=3.073,95%CI：1.832~12.627,P=0.001）是女性早发冠心病病人独立的危险因素。结论吸烟、女性早发冠心病家族史、Fg、TG是女性早发冠心病病人的独立危险因素,积极戒烟、改善不良生活方式能够预防女性早发冠心病的发生。

Objective To explore the characteristics of coronary artery lesions and risk factors in female patients with premature coronary artery disease（ CAD）. Methods Three hundreds patients with CAD were diagnosed by coronary angiogarphy from June 2012 to Apr 2015 in our hospital. Patients were divided into premature CAD group（ 150 cases） or non-premature CAD group（ 150 cases） according to results of coronary angiography. Three hundreds patients diagnosed of CAD were studied basic clinical characteristics,we compare two groups of patients with coronary artery lesion characteristics,and using multiariable Logistic regression to analysis of risk factors on patients with male premature coronary artery disease. Results Compared with non-premature CAD group,the patient in premature CAD group was more prevalent in acute coronary syndrome（ ACS）,smoking,family history premature CAD,and the levels of plasma fibrinogen（ Fg）,triglycerides（ TG） were higher（P〈0. 05）. In terms of coronary artery lesion characteristics,premature CAD group was prevalent in 1 vessel lesions,while there was no significant difference on lesions positions. Compared with non-premature CAD group,the average coronary artery lesions and Gensini score of every patients in premature CAD group was lower（P〈0. 05）. Conclusion Smoking,family history of premature CAD,Fg,TG are independent risk factors for female premature CAD patients,smoking cessation,changing unhealthy lifestyle can prevent the incidence of premature CAD.