绝经前后不同年龄冠心病患者危险因素及冠状动脉病变特征的差异

Risk factors and characteristic differences of coronary artery disease in coronary heart disease patients in different age groups before and after menopause

目的探讨绝经前后不同年龄冠心病患者危险因素及冠状动脉病变特征的差异。方法选取2009年1月-2015年8月经冠状动脉造影确诊冠心病患者(至少有1支主要冠状动脉狭窄程度≥50%)87例,分为未绝经冠心病组(19例),绝经时间≤10年冠心病组35例,绝经时间>10年冠心病组33例,进行对比分析。结果 1各组比较除体重指数和吸烟外,其余各指标均有统计学意义,其中未绝经组患者冠心病家族史、糖尿病及结缔组织病发生率最高;随着年龄的增加,各组高血压及高血脂的发生率逐渐升高;5例甲状腺功能低下患者均发生在绝经时间>10年的冠心病组。2各组患者临床心绞痛多不典型,以稳定型心绞痛及急性冠脉综合征为临床表现的患者比例无统计学意义(P>0.05),但在冠状动脉病变特征上各组存在统计学意义,其中未绝经冠心病组及绝经时间≤10年组冠状动脉病变以单支病变为主,绝经>10年组冠状动脉病变组以多支病变为主,组间比较均有统计学意义(P<0.05)。结论绝经前后冠心病患者的危险因素及冠状动脉病变特征存在差异,在临床可采取有效针对性的干预措施,及早诊治。

Objective To explore the risk factors and characteristic differences of coronary artery disease in coronary heart disease（CHD） patients in different age groups before and after menopause.Methods Eighty-seven patients diagnosed as CHD definitely by coronary angiography from January 2009 to August 2015 were selected,then they were divided into premenopausal group（19 cases）,menopause ≤10 years group（35 cases）,and menopause 10 years group（33 cases）,then the data was compared and analyzed.Results Excluding body mass index and smoking,there were statistically significant differences in the other indicators among the three groups.The incidence rates of CHD family history,diabetes and connective tissue diseases in premenopausal group were the highest.The incidence rates of hypertension and high cholesterol in the three groups gradually increased with age.Five cases with thyroid dysfunction were found in menopause〉10 years group.The clinical symptoms of angina were atypical,there was no statistically significant difference between the patients with stable angina pectoris and the patients with acute coronary syndrome（P〉0.05）,but there was statistically significant difference in the characteristics of coronary artery disease among the three groups,single vessel disease was the main type in premenopausal group and menopause≤10 years group,multiple vessels disease was the main type in menopause 〉10 years group,there was statistically significant difference（P〈0.05）.Conclusion There are differences in risk factors and characteristic differences of coronary artery disease in CHD patients in different age groups before and after menopause.Effective and targeted interventions are necessary for early clinical diagnosis and treatment.