早发与晚发冠心病患者临床及冠状动脉病变特点的性别差异分析  

Sex differences of clinical and coronary artery features in patients with premature and mature coronary heart disease

作　　者：郭福佳 袁正强 施尚鹏 周香 GUO Fujia;YUAN Zhengqiang;SHI Shangpeng;ZHOU Xiang(Zunyi Medical University,Zunyi,Guizhou,China,563000;Department of Cardiology,The third Affiliated Hospital of Zunyi Medical University)

机构地区：[1]遵义医科大学,贵州遵义563000 [2]遵义医科大学第三附属医院心内科

出　　处：《临床心血管病杂志》2021年第1期28-31,共4页Journal of Clinical Cardiology

基　　金：遵义市科技计划课题(No:遵市科合社字[2018]157号)。

摘　　要：目的:探讨早发与晚发冠心病患者临床及冠状动脉(冠脉)病变特点的性别差异。方法:收集2016年1月—2017年2月于我院心内科经冠脉造影(CAG)检查明确冠心病诊断的692例患者一般和临床资料,根据NECP-ATPⅢ规定将所纳入患者分为早发冠心病组(男性110例、女性83例)与晚发冠心病组(男性298例、女性201例),分析早发与晚发冠心病患者临床及冠脉病变特点的性别差异。结果:早发组中,男性吸烟、饮酒、有冠心病家族史、有高血压家族史、右冠脉病变、ST抬高型心肌梗死(STEMI)的比例以及血清尿酸(UA)、同型半胱氨酸(HCY)水平较女性高,患高血压、单支病变、稳定型心绞痛(SAP)的比例及血清高密度脂蛋白胆固醇(HDL-C)、载脂蛋白(APO)A、APOA/APOB水平较女性低(均P<0.05);晚发组中,男性吸烟、饮酒、STEMI的比例以及UA、HCY水平较女性高,患高血压、SAP的比例以及血清总胆固醇(TC)、HDL-C、APOA、APOA/APOB、血小板(PLT)水平较女性低(均P<0.05)。早发组男性吸烟、饮酒、有冠心病家族史、有高血压家族史、双支病变、STEMI的比例以及BMI、血清TC、LDL-C、甘油三酯(TG)、PLT水平较晚发组男性高,患高血压的比例以及血清HDL-C、APOA/APOB较晚发组男性低(均P<0.05);早发组女性单支病变比例、血清TC水平较晚发组女性高,3支病变、右冠脉病变比例以及血清UA、HCY较晚发组女性低(均P<0.05)。结论:吸烟、饮酒、血清高水平UA、HCY是男性冠心病患者的主要危险因素,高血压是女性冠心病患者的主要危险因素。此外,血清高水平TC、TG、LDL-C、PLT以及BMI增高与男性冠心病的早发有关,血清高水平TC与女性冠心病的早发有关。Objective:To investigate sex differences of clinical and coronary artery features in patients with premature coronary artery disease(CHD)and mature CHD.Methods:The general and clinical data of 692 patients diagnosed with CHD by coronary angiography(CAG)from January 2016 to February 2017 in our hospital were collected.According to the NECP-ATPⅢregulations,all included patients were divided into premature CHD group(110 males and 83 females)and mature CHD group(298 males and 201 females).Sex differences in clinical and coronary artery features in the two groups were compared.Results:In the premature CHD group,compared with female patients,male patients showed higher incidences of smoking,drinking,family history of CHD,family history of hypertension,right coronary artery(RCA)disease and ST elevation myocardial infarction(STEMI),as well as higher levels of serum uric acid(UA),homocysteine(HCY);while showed lower proportions for combining hypertension,single vessel disease and stable angina pectoris(SAP),and lower levels of serum high-density lipoprotein cholesterol(HDL-C),apolipoprotein A and B,APOA/APOB(all P<0.05).In the mature CHD group,compared with female patients,male patients showed higher rates of smoking,drinking and STEMI,and higher serum UA,HCY levels;while showed lower ratios for combining hypertension and SAP,and lower serum levels of TC,HDL-C,APOA,APOA/APOB,PLT(all P<0.05).Compared with female patients in the mature CHD group,female patients in the premature CHD group showed higher proportions of single vessel disease and serum levels of TC,while showed lower rates of three vessel disease,RCA disease and serum levels of UA and HCY(all P<0.05).Compared with male patients in the mature CHD group,male patients in the premature CHD group showed higher rates of smoking,drinking,family history of CHD,family history of hypertension,double vessel disease,STEMI,and higher levels of BMI,TC,LDL-C,TG and PLT;while showed lower proportionds of hypertension and levels of HDL-C,APOA/APOB(all P<0.05).Conclusion:Smokin

关 键 词：冠状动脉疾病 危险因素 病变特点 性别差异 

分 类 号：R541.4[医药卫生—心血管疾病]