急性冠状动脉综合征介入治疗预后的性别差异  

Gender difference on prognosis of patients with acute coronary syndrome undergoing percutaneous coronary intervention

作　　者：郑建勇[1] 马志敏[1] 张清潭[1] 吴桂萍[1] 袁彦菊[1] 李田昌[1] 

机构地区：[1]首都医科大学附属北京同仁医院心血管疾病诊疗中心,北京100730

出　　处：《临床荟萃》2007年第11期763-766,共4页Clinical Focus

摘　　要：目的探讨性别对急性冠状动脉综合征(ACS)介入治疗预后的影响。方法分析比较363例ACS患者(男性244例,女性119例)的临床和冠状动脉造影病变特征、介入治疗的造影成功率、院内和随访(22±13)个月主要心脏不良事件(MACE)的发生率和病死率。结果女性年龄较大,合并高血压的比例较大,血胆固醇和低密度脂蛋白的平均浓度较高,但吸烟和既往心肌梗死的比例较低。男性多支病变的比例较高(50.4%vs 36.1%,P=0.010),侧支循环较多,而女性双支病变的比例较高(25.8%vs 36.1%,P=0.042),钙化病变较多。两组介入治疗的造影成功率(91.4%vs 94.1%,P=0.361)、院内MACE(5.7%vs 5.9%,P=0.956)和随访期间MACE(13.3%vs 13.4%,P=0.982)相似。但在年龄低于65岁的患者中,女性随访期间的病死率显著高于男性(0.7%vs 7.7%,P=0.029)。结论性别不是影响ACS患者介入治疗术后院内和长期MACE的重要因素,但在年龄低于65岁的患者中,女性长期病死率较高。Objective To investigate the impact of gender on the prognosis of the patients with acute coronary syndrome（ACS） undergoing percutaneous coronary intervention（PCI）. Methods Analysis was conducted on 363 ACS cases（male 244 vs female 119） who had undergone PCI for their clinical characteristics, angiographic characteristics, angiographic success,major adverse cardiac events （MACE） and mortality in hospital and during （22 ±13） months＂ follow-up. Results Women were older, and had a higher prevalence of hypertension and a higher mean level of serum cholesterol and low density lipoprotein,but were less smokers or had prior myocardial infarction. Men had more multivessel disease （50.4% vs 36.1%, P = 0. 010） and collateral circulation, while women had more two-vessel disease （25.8% vs 36.1 %, P = 0. 042） and calcified lesions. The angiographic success rate following PCI （91.4 % vs 94.1 %, P =0. 361） and the incidences of MACE in hospital （5.7% vs 5.9% P =0. 956） and during follow-up （13.3% vs 13.4 %, P = 0. 982） were similar between two groups. Among patients younger than 65 years old,the female mortality during follow-up was higher than that of men（0.7% vs 7.7%, P =0. 029）. Conclusion Gender is not an important factor related to the in-hospital and long-term MACE of the patients with ACS treated by PCI, but among patients younger than 65 years old,the long-term mortality of women is higher.

关 键 词：冠状动脉疾病 性别因素 血管成形术 经腔 经皮冠状动脉 

分 类 号：R543.31[医药卫生—心血管疾病]