冠状动脉造影评价女性冠心病心绞痛的诊断问题  

CLINICALDIAGNOSTICPROBLEMSOFTHEFEMALECORONARYHEARTDISEASEEVALUATEDBYCORONARYARTERYANGIOGRAPHY

作　　者：陈步星[1] 徐成斌[1] 田雅文[1] 王伟民[1] 赵红[1] 

机构地区：[1]北京医科大学人民医院心内科

出　　处：《中华内科杂志》1996年第4期239-241,共3页Chinese Journal of Internal Medicine

摘　　要：为了解女性冠心病心绞痛的临床诊断问题，本组回顾性分析１００例女性患者临床诊断冠心病心绞痛行冠状动脉（冠脉）造影检查的临床资料。冠心病组：以冠脉造影血管狭窄≥７５％诊断为冠心病，冠脉狭窄５０％～７５％且临床有心肌缺血证据者也诊断为冠心病，共４８例。冠脉造影结果除外冠心病者５２例，为对照组。比较二者有关冠心病危险因素和临床胸痛特点。结果显示绝经是女性冠心病特殊危险因素，绝经后冠心病发生率增加。女性冠心病临床胸痛症状常不典型，绝经后出现典型或不典型胸痛，同时又有明显冠心病危险因素，发生冠心病可能性大。绝经后仅有典型或不典型胸痛，而无明显危险因素，则发生冠心病可能性较小。Theclinicaldataof100femalecaseswithsuspectedcoronaryheartdisease(CHD)under-goingcoronaryarteryangiography(CAA)wereanalysed.CHDwasdefinedasanestimateddiametersteno-sisof75%andmoreinthemaincoronaryarteriesorcoronarystenosisof50%～75%withevidenceofcar-diacischemia.Forty-eightcasewereconfirmedashavingCHDbyCAA.Theremaining52caseswerecon-firmedasnon-CHDandservedasthecontrolgroup,including49caseswithnormalcoronaryarteriesand3caseswithstenosisoflesthan50%intherightcoronaryarteryorleftanteriordescendingartery.TheriskfactorsofCHDandclinicalcharacteristicsofchestpainwerecomparedforthetwogroups.ThedatademonstratedthatmenopausewasaspecialriskfactorforfemalesandtheincidenceofCHDwasincreasingwithagingaftermenopause.However,theclinicalcharacteristicsofchestpaininfemaleCHDwereusualyatypical.Whenchestpain,whetherclinicalytypicaloratypical,werepresentaftermenopauseandaccom-paniedbyevidentriskfactors,theprobabilityofCHDwouldbehigh.Iftherewasonlychestpainwithoutanyriskfactoraftermenopause,thediagnosisofCHDwouldbeleslikely.

关 键 词：冠心病 心绞痛 诊断 冠状动脉造影 女性 评价 

分 类 号：R541.404[医药卫生—心血管疾病] R816.2[医药卫生—内科学]