绝经前女性冠心病患者危险因素及临床特点分析  

Clinical Profile of Premenopausal Women with Coronary Heart Disease

作　　者：丁荣晶[1] 贾三庆[1] 王雷[1] 李宏伟[1] 南芳[1] 张宇晨[1] 陈辉[1] 王永亮[1] 

机构地区：[1]首都医科大学附属北京友谊医院心血管中心,北京100050

出　　处：《医学临床研究》2006年第11期1788-1790,共3页Journal of Clinical Research

摘　　要：【目的】探讨绝经前女性冠心痛的危险因素和临床特点。【方法】连续入选2000～2006年“疑诊冠心病”入住本院心脏中心的绝经前女性患者166例，根据冠状动脉造影结果分为冠心病组和冠脉正常组。回顾分析冠心病组的危险因素、临床症状及其冠脉病变特点。【结果】患者166例，其中冠心病组80例，平均年龄43．8±5．6岁；冠脉正常组86例，平均年龄44．6±4．5岁。两组之间危险因素比较；合并高血压分别为63．7％vs15．1％，合并糖尿病分别为47．5％VS8．1％，合并高脂血癌分剐为52．5％vs16．2％，两组比较差异显著（P〈0．05）；而其他女性冠心病高危因素如冠心痛家族史、吸烟、肥胖、是否进行激素替代治疗两组之间比较未见统计学差异（P〉0．05）。临床症状比较：冠心痛组心绞痛症状典型多见（64／80例，80％vs10／86例，11．6％）；特异性心电图变化冠心病组66／80例，正常组28／86例，ST—T改变多见于冠心痛组（50／66例．75．8％VS6／28例，21．4％），单独T渡改变多见于冠脉正常组（16／66例，24．2％VS22／28例，78．6％）。共有100例患者行平板运动试验，诊断敏感性66．7％，特异性32．2％。76例行核素心肌灌注显像，诊断敏感性40．9％，特异性59％。冠脉病变以单支病变多见，占82．5％，前降支是最易累厦的血管。【结论】高血压、糖尿病和／或高脂血症为绝经前女性冠心病重要危险因素。绝经前女性典型心绞痛伴STT改变应高度怀疑冠心病。无创检壶诊断绝经前女性冠心病价值均有限。可作为筛选高危人群的指标。[Objective]To study the clinical profile of premenopausal women with coronary heart disease （CHD）. [Methods]One hundred sixty six premenopausal women with chest pain were classified into CHD group and control group by coronary angiography. Risk factors,clinical symptoms and the coronary angiographic characteristics were investingated retrospectively. [Results]The risk factors of premenopausal women with CHD were hypertension.DM and hyperlipidemia. Typical angina pectoris wes an important character of such CHD people. The change of ECG in premenopausal women with CAD was elevation or depression of ST , but not T wave. The sensitivity and specificity of Exercise stess testing or SPECT for premenopausal women with CAD were 67.7% and 32.2% ,40.9% and 59%, respectively. Single vessel coronary disease was seen more frequently,and the left anterior disending artery was the most frequently involved vessel. [Conclusion]Hypertension, Diabetes and/or hyperlipidemia are major risk factors in premenopausal women with CHD. Those with typical angina pectoris and ST-T changes should be attached importance on. Nonvasive testing is poor pridictor for young women with CAD,but can be used as excludsive marker of high risk.

关 键 词：冠状动脉疾病 危险因素 绝经 

分 类 号：R543.3[医药卫生—心血管疾病]