不同性别无症状心肌缺血患者接受经皮冠状动脉介入治疗冠状动脉病变特点及差异

Impact of gender on coronary lesions of silent myocardial ischemia patients treated with percutaneous coronary intervention

目的探讨不同性别无症状心肌缺血(SMI)患者经皮冠状动脉介入治疗(PCI)的冠状动脉病变特点及差异。方法选取自2015年1月至2018年5月入选"全军心血管介入诊疗管理系统"数据库且接受PCI的1460例SMI患者为研究对象,并将其分为男性组(n=1165)与女性组(n=295)。比较两组患者的基线资料、冠状动脉病变血管分布、诊断、靶血管分布、术前狭窄程度及病变特点。结果男性组平均年龄、合并高血压的患者比例均低于女性组,合并心肌梗死及近期吸烟史的患者比例明显高于女性组,组间比较,差异均有统计学意义(P<0.05)。两组患者的病变血管分布及诊断方面比较,差异均无统计学意义(P>0.05)。男性组处理左冠状动脉回旋支(LCX)的患者比例明显高于女性组,差异有统计学意义(P<0.05)。男性组术前轻度狭窄靶血管比例明显高于女性组,而重度狭窄靶血管比例则明显低于女性组,差异均有统计学意义(P<0.05)。两组在病变特点方面比较,差异均无统计学意义(P>0.05)。结论接受PCI治疗的女性SMI患者年龄更大,合并高血压比例更多,PCI术前冠状动脉狭窄程度更重;而男性SMI患者合并心肌梗死及接受LCX介入比例更高。

Objective To investigate the impact of gender on coronary lesions of patients diagnosed as silent myocardial ischemia(SMI)and treated with percutaneous coronary intervention(PCI).Methods A total of 1 460 SMI patients who received PCI and were selected from January 2015 to May 2018 as the research objects, and were selected from the database of military cardiovascular interventional treatment and management system".Andthey were divided as male group(n=1 165)and female group(n=295).Baseline characteristics, distribution and diagnosis of coronary lesions, distribution of target vessels, extend of stenosis and lesion features pre-procedure were compared and analyzed.Results The average age and the proportion of patients complicated with hypertension in male group were lower than that in female group, and the proportion of patients complicated with myocardial infarction and recent smoking history was significantly higher than that in female group, with statistical significance(P<0.05).There was no significant difference in the distribution of diseased vessels and diagnosis between two groups(P>0.05).The proportion of patients treated with left coronary circumflex branch(LCX)in male group was significantly higher than that in female group, and the difference was statistically significant(P<0.05).The proportion of target vessels with mild preoperative stenosis in male group was significantly higher than that in female group, while the proportion of target vessels with severe stenosis was significantly lower than that in female group, with statistical significance(P<0.05).There was no significant difference in pathological characteristics between the two groups(P>0.05).Conclusion The SMI women treated with PCI were older, more likely to have hypertension, and had more severe coronary stenosis before PCI.Then the proportion of male SMI patients with myocardial infarction and LCX intervention was higher.