绝经前子宫切除术与冠状动脉粥样硬化程度的相关性研究

Correlation between premenopausal hysterectomy and severity of coronary atherosclerosis

目的探讨绝经前子宫切除术与冠状动脉(冠脉)粥样硬化病变程度的相关性。方法收集2015年1月至2018年7月于孝感市中心医院心血管内科行冠脉造影检查发现有冠脉粥样硬化的932例患者为研究对象,根据是否于绝经前行子宫切除术分为2组:子宫切除组(研究组,n=74)及非子宫切除组(对照组,n=858)。比较两组患者的冠脉粥样硬化病变程度是否有显著差异。结果研究组中患者合并有高血压(P=0.016)、糖尿病(P=0.005)、高血脂(P=0.008)、肥胖(P=0.016)的比例明显高于对照组。对冠状动脉粥样硬化性心脏病(冠心病)危险因素基线水平进行调整后,研究组的Gensini评分高于对照组,差异具有统计学意义(P=0.004)。结论绝经前行子宫切除术的女性患高血压、糖尿病、高血脂及肥胖的风险比普通女性高,这可能是导致绝经前行子宫切除术的女性患者冠心病的患病率及病变程度均高于普通女性的原因。

Objective To investigate the correlation between premenopausal hysterectomy and severity of coronary atherosclerosis.Methods The patients with coronary atherosclerosis(n=932)diagnosed by coronary angiography(CAG)were chosen from Department of Cardiovascular Medicine in the Center Hospital of Xiaogan City from Jan.2015 to July 2018.All patients were divided,according to whether they received premenopausal hysterectomy,into hysterectomy group(study group,n=74)and non-hysterectomy group(control group,n=858).The difference in severity of coronary atherosclerosis was compared between 2 groups.Results The proportions of patients with hypertension(P=0.016),diabetes(P=0.005),hyperlipidemia(P=0.008)and obesity(P=0.016)were significantly higher in study group than those in control group.After regulating the baseline level of risk factors for coronary heart disease(CHD),the scores of Gensini were higher in study group than those in control group(P=0.004).Conclusion The female patients undergone premenopausal hysterectomy have higher risk of hypertension,diabetes,hyperlipidemia and obesity than ordinary women.It may be the reason for higher prevalence and severity of CHD in female patients undergone premenopausal hysterectomy.