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目的目前,关于女性冠心病的种族差异研究较少。文中比较了黄种人与白种人女性拟诊冠心病患者的临床表现、冠状动脉造影(coronary artery angiography,CAG)特点及危险因素。方法 2644例女性按照人种分为黄种人组和白种人组,再分别按年龄分为中青年组(<60岁)和老年组(≥60岁)共4组。比较各组临床表现、CAG特点及危险因素的差异。结果①各年龄组黄种人女性稳定性心绞痛(stable angina pectoris,SA)发病率均显著低于同龄白人女性(5.4% vs 54.6%、7.9% vs 53.4%,P<0.01),而不稳定性心绞痛(unstable angina pectoris,UA)和不典型胸痛的发病率均显著高于同龄白人女性(29.0% vs 15.5%、35.2% vs 24.2%,58.4% vs 20.7%、44.9% vs 14.6%;P<0.01)。②黄种人和白种人女性CAG阳性率在相同年龄段内差异无显著性统计学意义(44.8% vs 47.1%、68.9% vs 69.8%,P>0.05)。冠脉病变累及的血管均依次为左前降支(left anterior descending branch,LAD)、右冠状动脉(right coronary artery,RCA)、左回旋支(left circumflex branch,LCX)、左主干(left main coronary artery,LM)。黄种人女性中青年组3支血管病变百分率显著低于同龄白人女性(8.8% vs 17.7%,P<0.01),但黄种人和白种人女性3支病变率均随年龄增长而增高(8.8% vs 24.9%、17.7% vs 29.0%,P<0.01)。③黄种人女性高血压的检出率均显著高于同龄白人女性(59.2% vs 45.1%、71.9% vs 62.1%,P<0.01),但高血脂的检出率均显著低于同龄白人女性(18.4% vs 68.9%、15.9% vs 66.3%,P<0.01)。黄种人女性中青年组糖尿病的检出率显著低于同年龄白人女性组(15.9% vs 66.3%,P<0.01),而老年组糖尿病的检出率虽低于白人女性组,但差异无统计学意义(23.7% vs 26.2%,P>0.05)。结论黄种人女性UA及不典型胸痛发病率显著高于白人女性,但白人女性SA和3支血管病变率显著高于黄种人女性。高血压是黄种人女性冠心病重要的致病因素,而高血脂和糖尿病是白人女性冠心病重要的致病因素。
Objective Currently, there are few studies on racial differences in women with coronary heart disease. The clinical manifestations, coronary artery angiography (CAG) characteristics and risk factors of yellow and white female patients with suspected coronary heart disease were compared. Methods A total of 2644 women were divided into yellow group and Caucasian group according to race. Four groups were divided into young group (<60 years old) and elderly group (≥60 years old) by age. Compare the clinical manifestations of each group, CAG characteristics and risk factors. Results ① The incidence of stable angina pectoris (SA) in yellowish women of all age groups was significantly lower than that of white women of the same age (5.4% vs 54.6%, 7.9% vs 53.4%, P <0.01), while unstable angina The incidence of unstable angina pectoris (UA) and atypical chest pain were significantly higher than those of the same age female (29.0% vs 15.5%, 35.2% vs 24.2%, 58.4% vs 20.7%, 44.9% vs 14.6%, P <0.01) . ② The positive rate of CAG in yellow and white women was not statistically significant in the same age group (44.8% vs 47.1%, 68.9% vs 69.8%, P> 0.05). The vessels involved in coronary artery lesion were left anterior descending branch (LAD), right coronary artery (RCA), left circumflex branch (LCX), left main coronary artery , LM). The percentage of 3 vessel disease in the yellow group was significantly lower than that in the same age white female (8.8% vs 17.7%, P <0.01). However, the 3 vessel lesion rates in both the yellow and white female groups increased with age (8.8% vs 24.9%, 17.7% vs 29.0%, P <0.01). (3) The prevalence of hypertension in yellowish people was significantly higher than that in Caucasian women of the same age (59.2% vs 45.1%, 71.9% vs 62.1%, P <0.01), but the detection rate of hyperlipidemia was significantly lower than that of white women 18.4% vs 68.9%, 15.9% vs 66.3%, P <0.01). The detection rate of diabetes in young and middle-aged women in yellow group was significantly lower than that in white female group (15.9% vs 66.3%, P <0.01), while the incidence of diabetes in elderly group was lower than that in white female group Significance (23.7% vs 26.2%, P> 0.05). Conclusions The incidence of UA and atypical chest pain in yellowish women is significantly higher than that in white women, but the SA and 3-vessel disease rates in white women are significantly higher than those in yellowish women. Hypertension is an important risk factor for coronary heart disease in yellowish women, while hyperlipidemia and diabetes are the important risk factors for coronary heart disease in white women.