女性冠心病临床及冠状动脉病变特点分析

The clinical and characteristics of coronary artery lesions in female patients with coronary heart disease

目的 了解女性冠心病的临床与冠状动脉(冠脉)病变特点,以提高诊断水平。方法 以男性为对照,回顾性分析135例女性冠心病患者的临床资料及冠脉造影结果。结果 年龄<60岁,女性冠心病检出率明显低于男性;年龄≥60岁,女性明显高于男性。年龄<60岁,女性患病平均年龄较男性晚(56.4±3.2岁 vx47.4±6.2岁,P<0.05);有高血压病者显著高于男性,但糖尿病、高脂血症无显著性差异,发病时临床症状不典型,心电图ST-T改变不明显,冠脉病变较轻。年龄≥60岁时,女性冠心病有高脂血症者显著高于男性,两组高血压病、糖尿病无差异,临床症状比较典型,特异性ST-T改变仍不明显,但冠脉病变较严重,单支血管(前降支)病变减少。结论 女性冠心病临床症状多不典型,随着年龄增长,女性冠心病检出率显著增加,冠脉病变逐渐加重,应及早做冠脉造影检查以明确诊断。

Objective To Study the characteristics of clinical and coronary lesions in female patients with coronary heart disease(CHD) so as to contribute to the improvement of diagnostic level. Methods The clinical data and results of selected coronary angiography(SCA) of 135 female patients with CHD were analyzed, 150 male patients with CHD were served as the control group. Results In cases<60,the incidence of CHD in female patients was lower than that in males (32. 3% vs 67. 7%, P<0.05). In cases≥60, the incidence of CHDin female patients was higher than that in males(59. 5% vs 40.5%, P<0.05). The average incidence age in female patients (<60) withCHD was late (56. 4 ± 3. 2 vs 47. 4 ± 6. 2, P<0.05). The incidence of hypertension was higher than that in male patients younger than60, but the incidence of diabetes mellitus and hyperlipidemia were balanced between the two groups, clinical characteristics of chest pain wasatypical. ST-T changes in electrocardiogram were not obvious. Coronary lesions were light. In female patients with CHD elder than 60, hyper-lipidemia incidence was higher. Hypertension and diabetes mellitus were not different between the two groups. Clinical characteristics of chestpain were typical. Special ST-T changes were not obvious. Coronary lesions were serious. The number of single vesse lesion was decreased.Conclusions The clinical characteristics were atypical in non-old female patients. With age increasing gradually, the incidence and the coro-nary artery lesions in female with CHD were increased. In order to make righ diagnosis, female patiemts should be examined by coronary an-giography (CA) in time.