不同性别早发冠心病患者危险因素和冠脉病变特征的对比研究  

Gender Gap in Risk Factors and Coronary Artery Features in Patients with Premature Coronary Artery Disease

作　　者：鲁明[1] 王宁夫[1] 高炎[1] 李虹[1] 郭士遵[1] 钟益刚[1] 

机构地区：[1]南京医科大学附属杭州医院心内科,杭州310006

出　　处：《医学研究杂志》2012年第11期120-123,共4页Journal of Medical Research

基　　金：杭州市科技局重点项目(20080333Q03)

摘　　要：目的探讨不同性别早发冠心病(PCAD)患者的心血管危险因素和冠状动脉病变的特征。方法共入选经冠脉造影确诊为PCAD患者270例,分为男性组158例和女性组112例,对两组常见心血管危险因素(高血压史、糖尿病史、PCAD家族史、吸烟史、血脂异常病史、体重指数等)、血液指标(血脂、尿酸、纤维蛋白原、C反应蛋白等)和冠状动脉病变特征进行分析。结果男性组吸烟比例显著高于女性组(73.4%vs 1.8%,P<0.001),两组间高血压、糖尿病、PCAD家族史、肥胖、血脂异常病史无统计学差异(P>0.05),男性组血尿酸水平高于女性组(P<0.05),高密度脂蛋白胆固醇和Apoa水平低于女性组(P<0.05),但高尿酸血症两组间无统计学差异(P>0.05),低高密度脂蛋白血症在两组间存在统计学差异(P<0.05)。男性组冠脉慢血流、长病变发生率高于女性组(P<0.05),Gensini冠脉积分高于女性组(P<0.05)。结论男性PCAD患者冠脉病变严重程度高于女性,与吸烟以及吸烟所致血脂代谢紊乱、冠脉保护机制降低有关。Objective To characterize the risk factors and coronary artery lesion in patients with premature coronary artery disease （PCAD） between genders. Methods A total of 270 patients diagnosed by coronary angiography were divided into male group （ 〈 55 years, n = 158 ）and female group （ 〈 65 years, n = 112 ）. We collected the cardiovascular risk factors （hypertension, diabetes, family his- tory of premature coronary artery disease, smoking, dyslipidemia, body mass index, etc） , blood parameters （ cholesterol,total bilirubin, u- ric acid,fibrinogen,CRP）and coronary artery features for statistical analysis. Results Smoking was more prevalent among men （73.4% vs 1.8% ,P 〈 0. 001 ）. There were no significant diferences in the prevalence of hypertension, diabetes, family history, obesity,and dys- lipidemia（ P 〉 0.05 ）. The male group had higher level of bilirubin uric acid ,lower levels of blood HDL- C and Apoa （P 〈 0.05 ）. There was no significant difference in hyperuricemia between the two groups （ P 〉 0.05 ）. There was significant difference in the low density lipo- protein hyperlipidemia（P 〈 0.05）. There was a higher incidence of slow flow and long lesions with coronary artery in the male group who had a higher Gensini point（P 〈 0.05）. Conclusion The coronary artery lesion in males is less than that in females,because of the dys- lipidemia and low coronary protection caused by smoking.

关 键 词：早发冠心病 危险因素 性别 冠脉病变 

分 类 号：R544.1[医药卫生—心血管疾病]