PCI治疗急性心肌梗死的性别差异分析  

Clinical research of sex difference in patients with AMI after PCI treatment

作　　者：周志文[1] 李觉[1] 徐亚伟[2] 魏毅东[2] 余金明[1] 胡大一[1] 

机构地区：[1]同济大学心肺血管中心,上海200092 [2]同济大学附属第十人民医院心内科,上海200072

出　　处：《同济大学学报（医学版）》2009年第1期89-92,共4页Journal of Tongji University(Medical Science)

摘　　要：目的探讨女性急性ST段抬高性心肌梗死(ST-segment elevation myocardial infarction,STEMI)经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)与男性的临床差异。方法连续收集上海市第十人民医院心内科2006年1月—2008年1月期间因STEMI并行PCI治疗的患者240例,将其分为女性组(n=59,24.6%)和男性组(n=181,75.4%),回顾性分析两组的危险因素、就诊时间、急诊PCI比例、冠状动脉病变、心力衰竭和住院死亡率情况。结果与男性组相比,女性组发病年龄明显较大[(72.4±8.7岁)比(64.8±11.3岁),P<0.001],合并糖尿病和高脂血症的比例高(分别为40.7%比27.1%和57.6%比39.8%,P<0.05)。女性组就诊时间比男性组要迟(女性组均值为42.2 h,中值为16.0 h,四分位数间距为62.0 h;男性组均值为27.9 h,中值为7.0 h,四分位数间距为21.0 h,P<0.01),急诊PCI比例比男性组少(35.6%比58.0%,P<0.01)。在冠状动脉病变上两组差异无显著性。而在心力衰竭和住院死亡率上,女性组也比男组性高,但差异无显著性(分别为23.7%比13.9%和13.4%比7.2%);经调整年龄、就诊时间、糖尿病、高脂血症和急诊PCI比例后等因素后,住院死亡率性别差异无显著性。结论和男性相比,女性STEMI患者年龄大、危险因素多、就诊时间晚及急诊PCI比率低,心力衰竭和住院死亡率高。但就性别而言,住院死亡率差异无显著性(P=0.280)。Objective To study sex difference of clinical characters in patients with ST-segment elevation myocardial infarction （STEMI） treated with percutaneous coronary intervention （PCI）. Methods 240 cohort patients with STEMI treated with PCI in The Tenth Hospital of Shanghai City from 2006 to 2008 were selected. All patients were divided into two groups： men group and women group. We compared and analyzed the difference of risk factors, treating-time, acute-PCI rate, heart failure and in-hospital mortality between man group and women group. Results Compared with men group, women group were older [ （72. 4 ± 8.7 ） yrs vs （ 64.8 ± 11.3 ） yrs, P 〈 0. 001 1 , had more diabetes and hyperlipidemia （40.7 % vs 27.1% and 57.6% vs 39, 8%, respectively, P 〈 0.05）, and had less acute-PCI （35.6% vs 58.0%, P 〈 0.01 ）. The treating time of women group is slower than that of men group （ mean 42. 2 h vs 27.9 h, median： t6.0 h vs 7.0 h, interquartile range： 62.0 h vs 21.0 h, P〈0.01 ）. Women group also have more heart failure and in-hospital mortality although there are no statistics difference. After adjustment, women and men had similar in-hospital mortality. Conclusion Compared with men, women with STEMI treated with PCI had the following characters： older, more risk factors, delaying-time of treatment, low rate of acute-PCI and high rate of heart failure and in-hospital mortality. However, gender is not an important factor related to the in-hospital mortality rates.

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗 临床特点 性别差异 

分 类 号：R542.2[医药卫生—心血管疾病]