未绝经女性患者冠状动脉事件临床特点分析

被引：5

作者：

田然

张抒扬

田庄

谢洪智

刘震宇

金晓峰

王崇慧

严晓伟

朱文玲

方全

机构：

[1] 中国医学科学院北京协和医学院北京协和医院心内科

来源：

中华心血管病杂志 | 2009年 / 04期

关键词：

冠状动脉疾病; 危险因素; 女(雌)性;

D O I：

暂无

中图分类号：

R686 [筋腱、韧带、滑囊疾病及损伤];

学科分类号：

1002 ; 100210 ;

摘要：

目的分析未绝经女性患者冠状动脉事件的临床特点。方法回顾性分析1995—2007年间于北京协和医院接受诊治的未绝经女性冠心病患者47例,已绝经女性冠心病患者172例和未绝经非动脉粥样硬化性冠状动脉疾病女性患者(non-AS CAD组)18例的临床表现。结果(1)与已绝经冠心病组比较:未绝经冠心病组的高血压、糖尿病、高脂血症的发生率较低(均P<0.01),既往发生胸痛较少(14.9%比82.6%,P<0.01),冠心病危险因素个数较少(1.04±0.98比2.21±0.10,P<0.01),急性冠状动脉综合征(ACS)较多(83.0%比48.8%,P<0.01);冠状动脉造影显示以单支病变为主(70.2%比29.1%,P<0.01),冠状动脉病变积分(Gensini评分)较低(10.5±7.2比56.5±27.0,P<0.01);logistic回归发现,肥胖是未绝经女性冠心病患者独立的危险因素(OR=3.655,95%CI:1.15～11.59,P=0.028)。(2)18例non-AS CAD患者占疑诊冠心病未绝经女性患者中的28%,其中16例以ACS起病。与未绝经冠心病组比较,血生化指标、危险因素、冠状动脉病变情况等差异均无统计学意义。结论未绝经女性冠心病患者较已绝经女性冠心病患者合并高血压、糖尿病、高脂血症者少,冠心病危险因素少;既往发生胸痛较少,以ACS起病多见;肥胖是独立的危险因素。非动脉粥样硬化性冠状动脉疾病也是引起未绝经女性患者发生冠状动脉事件的重要原因。

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