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目的探讨女性早发冠心病(CHD)患者的心血管危险因素和冠状动脉病变特点。方法纳入753例经冠状动脉造影确诊为早发CHD(男性<55岁,女性<65岁)患者,对男性组(507例)和女性组(246例)的3个常见心血管危险因素(糖尿病、血脂异常及高血压)和冠状动脉病变特点进行对比分析。结果早发CHD男性组和女性组平均年龄相近,女性组糖尿病患者比例显著高于男性组(33.74%vs19.13%,P<0.001),而高血压、血脂异常差异无显著意义(P>0.05)。早发CHD单支病变占49.14%,部位以前降支为主(70.65%),但2组冠状动脉造影结果比较,无论是狭窄程度、狭窄支数还是累及分支血管比例差异均无显著意义(P均>0.05)。2组左心室射血分数(LVEF)和左心室舒张末压(LVEDP)比较,差异无显著意义(P>0.05)。结论女性早发CHD冠状动脉病变并不轻于男性,对女性早发CHD应予重视;临床诊断女性早发CHD应强调危险因素的综合评估。
Objective To investigate the cardiovascular risk factors and coronary artery lesions in women with premature coronary artery disease (CHD). Methods A total of 753 patients with CHD diagnosed by coronary angiography (male <55 years, female <65 years) were enrolled in this study. Three common cardiovascular risk factors (diabetes mellitus , Dyslipidemia and hypertension) and coronary artery lesions were compared. Results The average age of CHD male subjects was similar to that of female subjects in the group of early onset CHD. The proportion of diabetic patients in the female group was significantly higher than that of the male group (33.74% vs 19.13%, P <0.001), but no significant difference in hypertension and dyslipidemia (P> 0.05 ). The incidence of single coronary artery disease in CHD was 49.14% and the anterior descending artery was predominant (70.65%). However, there was no significant difference between the two groups in coronary artery angiography, whether stenosis, stenosis or involvement of branch vessels (P All> 0.05). The left ventricular ejection fraction (LVEF) and left ventricular end diastolic pressure (LVEDP) in the two groups showed no significant difference (P> 0.05). Conclusion The prevalence of CHD in women with early onset coronary artery disease is not significantly lower than that in males, and should be paid more attention to in women with premature CHD. The clinical diagnosis of early CHD in women should be emphasized on the comprehensive assessment of risk factors.