喀什女性急性ST段抬高型心肌梗死临床及病变特征与风险预后因素

Clinical characteristics and risk factors in female patients with acute ST-elevation myocardial infarction in Karshigar context

目的探讨维吾尔族急性ST段抬高型心肌梗死(STEMI)的女性患者冠脉病变、介入治疗情况等临床特点,以及风险预后因素。方法纳入2019年11月至2021年1月因胸痛入住喀什地区第一人民医院并确诊为急性ST段抬高型心肌梗死的维吾尔族患者,共557例。其中女性组98例,男性组459例,回顾性分析患者病历资料、病变情况,采用Logistic回归分析女性院内死亡危险因素。结果女性组BMI指数、血肌酐水平、肌钙蛋白峰值等均低于男性组,而D-二聚体、NT-proBNP峰值、高密度脂蛋白胆固醇、心功能不全比率、以及合并高血压比率、合并糖尿病比率均高于男性组,P值均<0.05,差别有统计学意义。两组间梗死相关血管及病变血管支数情况差异无统计学意义(P>0.05)。女性组行PCI比率低于男性组,院内死亡率显著高于男性组(P<0.001),差异有统计学意义。血肌酐水平、D-二聚体与女性STEMI患者院内死亡密切相关(P<0.05)。结论(1)维吾尔族STEMI特性存在性别差异;(2)血肌酐、D-二聚体与维吾尔族女性STEMI患者院内死亡密切相关,应关注血肌酐及D-二聚体水平;(3)女性行PCI血运重建者的比率显著低于男性,女性未行PCI者死亡率显著高于行PCI术者。维吾尔族女性STEMI患者需要更多的关注,加强介入诊治,以改善预后。

Objective To explore the risk characteristics for Uygur women with acute ST-elevation myocardial infarction(STEMI)and decipher the factors related to in-hospital mortality among this population.Methods Clinical data of 98 female patients and 459 male patients presenting with STEMI treated from Nov 2019 to Jan 2021 in the No.1 People's Hospital of Kashi were analyzed retrospectively.Outcomes were compared according to gender.Results Female patients had lower BMI,serum creatinine,troponin and got less PCI performance(P<0.05).The D-dimer,NT-proBNP,high density lipoprotein cholesterol,grade of cardiac function,incidence of diabetes and hypertension of female patients were significantly higher than those of male patients.No significant differences of the lesion sites and the number of diseased vessles were demonstrated between male and female groups(P>0.05).Compared with male,female patients got higher in-hospital mortality(P<0.05).Serum creatinine and D-dimer were independently associated with in-hospital mortality in female patients with STEMI.Conclusions(1)There are gender differences in Uygur patients with STEMI.(2)Serum creatinine and D-dimer are closely related to in-hospital mortality of Uygur women with STEMI.(3)Uygur female get less PCI than male which might lead to the higher in-hospital mortality.More attention should be paid to cardiovascular intervention therapy in Uygur female patients presenting with STEMI to improve their prognosis.