绝经前女性首次心肌梗死临床和冠状动脉造影特点分析  

Clinical and Coronary Angiographic Features in Premenopause Women With First Myocardial Infarction

作　　者：郑昕[1] 李建军[1] 郭远林[1] 高展[1] 张朝阳[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院冠心病诊治中心,北京市100037

出　　处：《中国循环杂志》2008年第3期200-202,共3页Chinese Circulation Journal

摘　　要：目的:探讨绝经前女性首次心肌梗死临床和冠状动脉造影特点。方法:回顾性分析2002-01至2006-12期间,首次患心肌梗死并在发病1个月内行冠状动脉造影的59例绝经前女性(绝经前组)和93例绝经后女性(绝经后组)患者临床和冠状动脉造影特点。结果:绝经前组55.9有高血压;66.7低密度脂蛋白胆固醇≤2.59mmol/L;其总胆固醇[(4.61±1.31)mmol/L]和低密度脂蛋白胆固醇[(2.48±0.90)mmol/L]水平均明显低于绝经后组(P<0.05)。和绝经后组相比,绝经前组有胸痛史者少见,有早发冠心病家族史者多见(P均<0.05);冠状动脉造影显示非阻塞性病变多见,三支病变少见(P均<0.05);18.6的梗死相关血管表现为正常。心肌梗死后心功能及并发症情况绝经前女性和绝经后女性相似。结论:绝经前女性心肌梗死患者危险因素及冠状动脉病变特点和绝经后女性有所不同,应注意早期识别,积极预防。Objective：To investigate the clinic and coronary angiographic features in premenopause women with first myocardial infarction. Methods： We retrospectively studied 59 premenopause women and 93 postmenopause women with first acute myocardial infarction who were admitted to hospital from Jan. 2002 to Dec. 2006 and undergone coronary angiography within one month from onset of myocardial infarction, and the clinic and coronary angiographic features were assessed. Results： Among premenopause women, 55.9% had hypertension; 66. 7% had LDL cholesterol levels ≤ 2. 59 mmol/L; their total cholesterol levels （ 4. 61 ± 1.31 mmol/L） and LDL cholesterol levels （ 2. 48 ± 0. 90 retool/L） were lower than that of postmenopause women（ P 〈 0. 05 ）. Premenopause women had more familial history of early coronary artery disease and less history of chest pain compared with postmenopause women（P 〈0.05 ）. Coronary angiography showed that premenopause women had more nonobstructive disease and less three-vessel disease than that of postmenopause women （P 〈 0. 05 ） , and 18.6% of premenopause women showed angiographically normal infarction related artery. The left ventricular function and complication were similar between premenopause and postmenopause women. Conclusion：Compared to postmenopause women, premenopause women with first acute myocardial infarction differ in coronary risk factors and angiographically features, and should be identified earlier and prevented actively.

关 键 词：绝经前女性 心肌梗塞 危险因素 冠状动脉造影 

分 类 号：R541.4[医药卫生—心血管疾病]