经皮冠状动脉介入治疗患者二级预防的性别差异分析  

Gerder differences of coronary heart disease secondary prevention in patients post percutaneous coronary intervention

作　　者：韩晓宁[1] 蒋捷[1] 张岩[1] 于荣辉[1] 龚艳君[1] 洪涛[1] 霍勇[1] 

机构地区：[1]北京大学第一医院心内科,北京100034

出　　处：《中国介入心脏病学杂志》2014年第3期137-140,共4页Chinese Journal of Interventional Cardiology

基　　金："十一五"国家科技支撑计划课题(2006BAI01A02)

摘　　要：目的在已经接受经皮冠状动脉介入治疗(PCI)的冠状动脉粥样硬化性心脏病(冠心病)患者中,了解二级预防治疗现状的性别差异。方法对31家三级甲等医院中至少有一次PCI史的门诊或住院冠心病患者进行病史采集和实验室检查,比较不同性别患者在戒烟、控制体重、血压、血脂以及药物治疗等各方面的差异。结果 4532例患者中,女性1151例,占全部PCI患者的25.4%。女性患者有吸烟史的比例明显低于男性患者,但戒烟比例与男性患者差异无统计学意义[52.1%(98例)比51.0%(1344例),P=0.849]。男性患者的平均体重指数、平均腰围和超重比例均大于女性患者(P=0.000),但女性的腰围不达标比例高于男性(59.2%比42.2%,P=0.000)。女性患者合并高血压、高脂血症和糖尿病的比例均高于男性,差异具有统计学意义(P=0.000)。且女性患者血压、血脂和血糖的控制达标比例均低于男性患者,分别为[血压:65.4%比73.1%,P=0.000;低密度脂蛋白胆固醇(LDL-C):45.2%比54.7%,P=0.000;空腹血糖:52.7%比58.8%,P=0.000]。不同性别患者二级预防药物使用率差异无统计学意义。结论接受PCI的女性冠心病患者合并冠心病危险因素多于男性,而除戒烟和体重控制外,各项危险因素控制达标率均低于男性,女性患者二级预防用药水平与男性相当。Objective To investigate the gender differences of coronary heart disease secondary prevention status in patients post percutaneous coronary intervention （PCI）. Methods Patients diagnosed with coronary heart disease from 31 tertiary hospitals were enrolled for a baseline survey. Medical history and laboratory tests were taken. Analysis was done for outpatient or inpatient with the history of at least one PCI treatment. Status of smoking cessation, weight management, blood pressure ＆lt; 140/90 mm Hg, low-density lipoprotein cholesterol （LDL-C） ＆lt; 100 mg/dL （2.6 mmol/L）, and use of antiplatlet drugs, beta-blockers, angiotensin-converting enzyme （ACE） inhibitors/angiotensin receptor blockers （ARB） and statins were collected and compared. Results Women （n=1151） accounted for 25.4% of all PCI patients （n=4532）. Proportion of female with history of smoking was signiifcantly lower than male, but the proportion of quitting was similar between female and male, 53%（n=98） vs. 53.7%（n=1344）, P=0.849. The average body mass index, mean waist circumference and proportion of overweight were higher in＆amp;nbsp;man than women, P=0.000. However, the proportion of abdominal obesity in women is higher than men, 75.2%vs. 52.8%, P=0.000. More female were comorbid with hypertension, hyperlipidemia and diabetes than male and the differences were signiifcant, P=0.000. Control rate of blood pressure, LDL-C and fasting glucose were lower in women than in man, the differences were 66.2% vs 73.4% for blood pressure, 47.8%vs. 57.0%for LDL-C and 57.5%vs. 62.7%for fasting glucose, P=0.000. There was no signiifcant difference in medication usage between different genders. Conclusions In patients post pecutaneous coronary intervention, female patients had more risk factors than male while risk factor control rate was lower comparing with male. Medication usage for coronary heart disease secondary prevention was similar between different genders.

关 键 词：冠心病 介入治疗 二级预防 性别 

分 类 号：R541.4[医药卫生—心血管疾病]