不同性别冠心病患者冠状动脉粥样硬化斑块的血管内超声研究

Intravascular Ultrasound Study of Coronary Atherosclerotic Plaques in Male and Female Patients with Coronary Heart Disease

目的利用血管内超声探讨男女冠心病患者冠状动脉粥样硬化斑块的特点。方法选择确诊的冠心病患者,男性119例,女性98例,检测患者血糖、血脂、血压,记录年龄、身高,体重,吸烟史、糖尿病、高血压病史及家族史等资料;通过冠脉造影(CAG)及血管内超声(IVUS)检查左冠脉的前降支(LAD)和回旋支(LCX)、右冠脉(RCA),检测外弹力膜面积(EEMA)、管腔面积(LA)、斑块面积(PA)、斑块负荷(PB)及血管重构指数。结果女性患者的年龄大于男性(P<0.01),女性患者合并高血压病、糖尿病比例高于男性患者(P<0.05)。冠脉造影结果显示,女性患者RCA狭窄率高于男性,而男性左冠脉的狭窄率高于女性(P<0.05);IVUS检测结果显示,女性患者的EEMA、PA和PB小于男性(P<0.05),男、女性患者血管正性重构比例差异有统计学意义(P<0.05)。结论女性冠心病患者合并症更多,发病年龄更大,冠脉血管粥样斑块特点与男性明显不同。

Objective Intravascular ultrasound was used to investigate the characteristics of coronary atherosclerotic plaques in male and female patients with coronary heart disease. Methods The blood glucose,blood lipid,blood pressure,age,height,weight,history of smoking,diabetes,hypertension and family history were recorded in 119 male and 98 female patients,and the anterior descending branch of the left coronary artery（LAD） and LAD were examined by coronary angiography（CAG）and intravascular ultrasound（IVUS）. Spiral branch（LCX）,right coronary artery（RCA）,external elastic membrane area（EEMA）,lumen area（LA）,patch area（PA）,plaque load（PB） and vascular remodeling index were measured.Results The ages of female patients were greater than those of men（P〈0.01）,and the proportion of female patients with hypertension and diabetes was higher than that of male patients（P〈0.05）. The results of coronary angiography showed that the rate of RCA stenosis in female patients was higher than that in men,but the stenosis rate of left coronary artery was higher in men than in women（P〈0.05）. The results of IVUS test showed that EEMA,PA and PB in female patients were less than men（P〈0.05）,and the proportion of positive reconstruction of blood vessels in female patients and male patients was statistically significant（P〈0.05）. Conclusion Female patients with coronary heart disease have more complications,and the age of onset is larger. The characteristics of coronary atherosclerotic plaques of female patients are significantly different from those of men.