中年女性患者冠状动脉造影的临床特点分析  

The clinical risk factors and coronary angiography and coronary interventional characteristics of middle-aged women with suspected coronary heart disease

作　　者：闫建玲[1] 范中杰[1] 袁晋青[2] 郁琦[3] 徐苓[3] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院心内科,北京市100730 [2]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 [3]中国医学科学院中国协和医科大学北京协和医院妇产科,北京市100730

出　　处：《中国心血管病研究》2008年第10期728-731,共4页Chinese Journal of Cardiovascular Research

基　　金："十五"国家科技攻关计划(2004BA720A08)子课题

摘　　要：目的分析中年女性冠心病临床危险因素、冠状动脉造影及介入治疗特点,评价冠心病发病、危险因素构成、冠状动脉造影及介入治疗方面年龄和性别的差异。方法入选1998年1月1日至2006年12月30日9年间在我院临床疑诊冠心病、年龄40～79岁、行冠状动脉造影的住院患者5685例。根据年龄分为中年组(40～59岁)和老年组(60～79岁),根据性别分为女性组和男性组。以同龄男性及老年女性为对照,回顾性分析冠心病危险因素在中年女性的分布情况、冠心病的检出率、冠状动脉病变及介入治疗特点、肾动脉造影及介入治疗特点。结果①中年女性与同龄男性比较:血脂异常患病率女性(75.68%)显著低于男性(88.80%)(P<0.01);高血压患病率女性(59.42%)显著高于男性(50.66%)(P<0.01);糖尿病患病率女性(30.47%)与男性(33.42%)差异无统计学意义(P=0.98);陈旧心肌梗死患病率女性(11.48%)显著低于男性(42.50%)(P<0.01);脑卒中患病率女性(5.01%)与男性(4.77%)差异无统计学意义(P=0.82);肾功能下降患病率女性(1.71%)低于男性(2.87%)(P=0.07)。冠状动脉造影冠心病检出率女性(36.64%)显著低于男性(69.10%)(P<0.001);在冠心病患者中,冠状动脉受累血管数量及严重程度中年女性组比男性轻(P<0.01);介入治疗比例(58.87%)低于男性(67.08%)(P<0.01)。肾动脉狭窄检出率女性(8.62%)高于男性(4.97%)(P<0.05)。②中年女性与老年女性比较:血脂异常、高血压、糖尿病、陈旧心梗、脑卒中、肾功能不全患病率,冠状动脉造影阳性率,冠状动脉病变受累血管数量及严重程度,冠状动脉介入治疗比例,肾动脉狭窄检出率均显著低于老年女性组(P<0.01)。结论在临床疑诊冠心病而行冠状动脉造影的患者中,中年女性血脂异常、陈旧心梗患病率、冠心病检出率、冠状动脉病变受累血管数量及严重程度、介入治疗比例显著低于同龄男性及老年女性。Objective To analyze the clinical risk factors and characteristics of coronary angiography and coronary interventional of the middle-aged women patients with suspected coronary heart disease（CHD） in order to accessing the impact of gender and age on CHD. Methods This study enrolled patients with clinical suspected CHD and undergone coronary angiography from January 1998 to December 2006. A total of 5685 patients were included in this study. According to age and gender, the patients were divided into middle-aged （40-59 y） or old-aged （60-79 y） group and female or male group. The clinical and angiography details were recorded and retrospectively analyzed. Results （1） In middle-aged group, the morbidity of hyperlipidemia was significantly lower in women（75.68% ） than in men （88.80%） （P〈0.01）. The morbidity of hypertension was significantly higher in women （59.42%） than in men （50.66%）（P〈0.01 ）. The morbidity of diabetes had no differences between female （30.47%） and male group （33.42%）（P=0.98）. The morbidity of old myocardial infarction was 11.48% of women and 42.50% of man （P〈0.01）. The rate of confirmed CHD by coronary angiography was 36.64% of women and 69.10% of men（P〈0.01 ）.The seriousness of coronary artery sternosis were significantly less in female group than in male group（P〈0.01 ）. Women with confirmed CHD were less likely to be intervented than their male counterparts. （2） Compared middle-aged with old-aged female patients,the morbidity of phyperlipidemia,hypertension,diabetes, old myocardial infarction, the rate of confirmed CHD by coronary angiography, the rate of intervention were all significantly lower in middle-aged female than in old-aged female patients. Conclusion Significant age and gender bias has been identified in patients with clinical suspected CHD and undergone coronary angiography. The distribution of the clinical risk factors of CHD and the morbidity and seriousness of CHD is different in different age and gende

关 键 词：中年女性 冠状动脉造影 危险因素 冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]