不同性别急性冠脉综合征患者的临床特征分析：480例回顾性研究  

Comparison of clinical features between male and female patients with acute coronary syndrome:a retrospective report of 480 cases

作　　者：何菲[1] 殷跃辉[2] 李芝峰[1] 廖荣宏[1] 高崇瀚[1] 

机构地区：[1]重庆医科大学附属永川医院心内科,重庆402160 [2]重庆重庆医科大学附属第二医院心内科,400016

出　　处：《解放军医学杂志》2014年第6期489-493,共5页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨女性急性冠脉综合征(ACS)患者的临床特征、冠脉病变特点和住院预后情况。方法选择2010年1月-2013年10月在重庆医科大学附属永川医院住院治疗且接受冠脉造影(CAG)的486例ACS患者,其中女226例,男260例。回顾性分析患者的基本临床特征,选取其中≥60岁者分为老年女性组(n=193)和老年男性组(n=186),分析比较老年男性及女性ACS患者冠状动脉造影结果和住院期间的情况。结果女性组平均年龄、≥60岁的比例均高于男性组(P<0.05,P<0.01),糖尿病、肥胖、高血脂的发生率明显高于男性组(P<0.01或P<0.05),吸烟的比例显著低于男性组(P<0.01)。老年女性组1支病变比例明显少于老年男性组,但3支病变比例及Gensini积分明显高于老年男性组(P<0.01),PCI术中无复流现象发生率显著高于老年男性组(P<0.01),PCI术后并发症(迷走反射、出血、血肿等)发生率也较老年男性组高(P<0.05或P<0.01)。住院期间老年女性患者监护天数及住院总天数显著高于老年男性(P<0.05),再发心绞痛、再发心肌梗死、心力衰竭的发生率亦显著高于老年男性(P<0.01)。结论女性ACS患者平均年龄、老年比例明显高于男性。女性ACS的主要危险因素为糖尿病、肥胖和高脂血症。老年女性ACS患者冠状动脉病变程度较同龄男性严重,预后较同龄男性差,但住院期间的病死率无差异。Objective To investigate the clinical characteristics, the characteristics of coronary lesions, and in-hospital prognosis of female patients with acute coronary syndrome （ACS）. Methods Four hundred and eighty-six ACS patients （226 females and 260 males）, hospitalized and received coronary arteriography （CAG） in the Affiliated Yongchuan Hospital of Chongqing Medical University from January 2010 to October 2013, were enrolled in the present study. The essential clinical characteristics of all the patients were retrospectively analyzed. Those patients aged ≥ 60 years were divided into geriatric female group （n=193） and geriatric male group （n=186）, and the findings of CAG and the in-hospital manifestations were compared between two geriatric groups. Results As compared with male group, the mean age was significantly older, and the percentage of patients aged ≥60 years was higher in female group （P〈0.05, P〈0.01）. The incidences of diabetes, obesity and hyperlipemia were significantly higher （P〈0.01, P〈0.05）, and the rate of smoking habit was significantly lower in female group than in male group （P〈0.05）. The geriatric female patients were less likely to have single-vessel disease, but more likely to have three-vessel lesions and higher Gensini score （P〈0.05, respectively）. Geriatric female patients had a significantly higher rate of no-reflow phenomenon and PCI complications （vagal reflex, bleeding, hematoma, etc.） （P〈0.05, P〈0.01）. Geriatric female patients experienced a longer hospital days and intensive care unit stay （P〈0.05）, and had a higher incidence of recurrent angina pectoris, recurrent myocardial infarction, and heart-failure events （P〈0.01）. Conclusions The mean age and the percentage of patients aged ≥ 60 years are significantly higher in female ACS patients than in male ACS patients. Diabetes, obesity and hyperlipemia are the major risk factors among female ACS patients. The female ACS patients tend to have more severe corona

关 键 词：急性冠脉综合征 女性 临床特征 心血管造影术 

分 类 号：R541.4[医药卫生—心血管疾病]