青年和老年女性冠心病患者危险因素及冠状动脉造影特点分析  

Risk factors and angiographic characteristics in both young and elderly women with coronary heart disease

作　　者：李敏[1] 米树华[1] 周芸[1] 陈青[1] 张晓霞[1] 苏工[1] 

机构地区：[1]首都医科大学附属北京安贞医院特需医疗科,100029

出　　处：《中国医药》2014年第7期929-933,共5页China Medicine

基　　金：北京市教育委员会科技计划（KM201310025020）

摘　　要：目的探讨青年和老年女性冠心病患者的发病特点，为青年和老年冠心病防治提供理论依据。方法回顾性分析2007年1月至2013年12月于北京安贞医院住院行冠状动脉造影诊断为冠心病的青年女性患者（年龄18～44岁）248例和老年女性患者（60～80岁）240例的病历资料，记录并比较患者的危险因素、冠状动脉造影特点和血运重建情况。结果①青年女性冠心病组合并高血压、糖尿病、高胆固醇血症的比例均明显低于老年女性冠心病组[52.4%（130/248）比70.8%（170/240），16.9%（42/248）比56.7%（68/240），25.8%（64/248）比45.0%（108/240）]（均P〈0.05）；②青年女性冠心病组冠状动脉造影单支病变比例高于老年女性冠心病组[76.6%（190/248）比35.0%（84/240）]，三支病变比例低于老年女性冠心病组[3.2%（8/248）比30.8%（74/240）]（均P〈0.05）。③青年女性冠心病组接受单纯药物治疗者明显多于老年女性冠心病组[29.8%（74/248）比16.3% （39/240）]，行单支血管介入治疗者明显多于老年女性冠心病组[82.6%（133/248）比62.8%（113/240）]（P〈0.05）。④心肌梗死患者相应冠状动脉病变情况：青年女性组心肌梗死病史患者60例（24.2%），老年女性组心肌梗死病史患者57例（23.8%），差异无统计学意义。青年女性心肌梗死患者以单支病变为主的患者比例明显高于老年女性心肌梗死组[66.7%（40/60）比38.6%（22/57）]（P〈0.05），青年女性心肌梗死三支病变患者明显低于老年女性心肌梗死组[13.3%（8/60）比35.1%（20/57）]（P〈0.05）。⑤Logistic回归分析显示，与青年女性心肌梗死独立相关的危险因素依次是高血压、体重指数、高三酰甘油水平和冠心病家族史[比值比（OR）=22.182， 95%置信区间（CI）： 5.590～96.182，P=0.000；OR=0.892， 95%CI：0.858～0.969，P=0.004；OR=0.762， 95%CI：0.612～0.901，P=0.003；OR=0.357， 95%CI：ObjectiveTo investigate clinical characteristics of women with coronary heart disease（CHD）. MethodsClinical and coronary angiographic features were compared among 248 young women with CHD[60 cases with acute myocardial infarction （AMI）]and 240 elderly women with CHD（57 cases with AMI）; all patients underwent coronary angiography. Results （1）The proportion of hypertension, diabetes and hypercholesterolemia in young women was higher than that in elder women [52.4% （130/248） vs 70.8%（170/240）,16.9%（42/248） vs 56.7%（68/240）,25.8% （64/248） vs 45.0%（108/240）] （all P〈0.05）. （2）The proportion of coronary angiography single vessel disease in young women was higher than that in elder women [76.6% （190/248）vs 35.0% （84/240）]（P〈0.05）. 74 patients（30.8%） had three vessel disease in elderly women, which was higher than that in young women [13.3% （8/248） vs 35.1% （20/240）] （P〈0.05）.（3）Drug therapy and single vessel coronary percutaneous intervention in young women were higher than those in elderly women [29.8%（74/248）vs 16.3%（39/240）, 82.6%（133/248） vs 62.8%（113/240）]（P〈0.05）. （4）Totally sixty patients（24.2%） had AMI in young women group; fiftyseven patients（23.8%） had AMI in elder women group; there were no difference in the two groups. 40 patients（66.7%）in young women group with AMI had single vessel disease and 22 patients （38.6%） in elderly women group with MI had single vessel disease（P〈0.05）; 8 patients （13.3%） in young women group with MI had three vessel disease and 20 patients （35.1%） in elder women group with MI had three vessel disease （P〈0.05）.（5）Logistic regression analysis showed that essential hypertension, body mass index, triglyceride and family history of coronary heart disease were independent risk factors for young women with AMI[odds ratio（OR）=22.182,95% cofidence interval（CI）： 5.59096.182,P=0.000;OR=0.892,95%CI： 0.8580.969,P=0.004;OR=

关 键 词：冠心病 危险因素 冠状动脉造影 女性 

分 类 号：R541.4[医药卫生—心血管疾病]