绝经后女性冠心病患者冠状动脉病变程度及介入治疗情况

The degree of coronary artery disease and interventional treatment in postmenopausal women with coronary heart disease

目的 探讨绝经后女性冠心病患者冠状动脉病变程度及介入治疗情况。方法 回顾性分析北部战区总医院自2016年3月至2018年3月收治的行冠状动脉造影检查及支架植入术的3 521例女性冠心病患者的临床资料。根据接受介入治疗时是否绝经,将患者分为绝经组(n=3 348)和未绝经组(n=173)。比较两组患者的一般资料、冠状动脉病变程度及介入治疗情况。结果 与未绝经组患者比较,绝经组患者年龄更大,低密度脂蛋白水平更高,合并高血压和脑血管疾病史的比例更高,吸烟和具有冠心病家族史的比例更低,差异有统计学意义(P<0.05)。与未绝经组患者比较,绝经组患者靶血管位置为左前降支的比例更低,靶血管位置为左回旋支、右冠状动脉的比例更高,全闭病变、钙化病变的比例更高,SYNTAX评分更高,支架个数更多,支架总长度更长,平均支架直径更小,差异有统计学意义(P<0.05)。结论 与未绝经女性冠心病患者比较,已绝经者多为高龄,低密度脂蛋白水平更高,合并高血压和脑血管疾病史的比例更高,靶血管位置为左回旋支、右冠状动脉的比例更高,全闭病变、钙化病变的比例更高,植入支架个数更多,支架总长度更长。临床医师需了解绝经后女性冠心病患者的疾病特点,关注疾病的严重程度,加强防治工作;同时,加强绝经后女性的健康教育,提高其对危险因素的认识,加强高危因素的自我管理,以减少冠心病及冠状动脉严重病变的发生。

Objective To investigate the degree of coronary artery disease and interventional treatment in postmenopausal women with coronary heart disease.Methods The clinical data of 3521 female patients with coronary heart disease who underwent coronary angiography and stenting from March 2016 to March 2018 in General Hospital of Northern Theater Command were retrospectively analyzed.Patients were divided into a menopausal group(n=3348)and a non-menopausal group(n=173)according to whether they were menopausal at the time of intervention.The general data,the degree of coronary artery disease and the interventional treatment were compared between the two groups.Results Compared with the non-menopausal group,the menopausal group was older,had higher levels of low density lipoprotein,had higher rates of hypertension and cerebrovascular disease,and had lower rates of smoking and family history of coronary heart disease,with statistical significance(P<0.05).Compared with the non-menopausal group,the proportion of target vessels in the menopausal group with left anterior descending branch was lower,the proportion of target vessels in the left circumrotatory branch and right coronary artery was higher,the proportion of total closure lesions and calcification lesions was higher,SYNTAX score was higher,the number of stents was more,the total length of stents was longer,and the average stent diameter was smaller,with statistical significance(P<0.05).Conclusion Compared with non-menopausal women with coronary heart disease,postmenopausal women are more elderly,have higher levels of low density lipoprotein,a higher proportion of combined hypertension and cerebrovascular disease,a higher proportion of target vessels in the left circumrotatory branch and the right coronary artery,a higher proportion of total closed disease and calcification disease,more stents implanted,and a longer total length of stents.Clinicians should understand the disease characteristics of postmenopausal women with coronary heart disease,pay attention to the severity of the disease,and strengthen prevention and treatment.At the same time,strengthen the postmenopausal women's health education,improve their awareness of risk factors,strengthen the self-management of high risk factors,in order to reduce the occurrence of coronary heart disease and serious coronary artery disease.