老年女性缺血伴非阻塞性冠状动脉疾病特点分析  

Clinical characteristics of elderly female patients with ischemia with no obstructive coronary artery disease

作　　者：赵薇[1] 秦明照[1] 周建博[2] 高璐[1] Zhao Wei;Qin Mingzhao;Zhou Jianbo;Gao Lu(Department of Geriatrics and Endocrinology,Beijing Tongren Hospital of Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院老年科,100730 [2]首都医科大学附属北京同仁医院内分泌科,100730

出　　处：《中华老年心脑血管病杂志》2021年第10期1042-1045,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨老年女性缺血伴非阻塞性冠状动脉疾病(ischemia with no obstructive coronary artery disease,INOCA)患者的临床特点。方法回顾性分析我院老年INOCA患者147例临床资料,女性82例(55.8%),男性65例(44.2%)。采用全球急性冠状动脉事件注册(GRACE)评分进行危险分层。结果女性胸痛、吸烟及外周动脉粥样硬化比例明显低于男性(56.1%vs 73.8%,P=0.026;14.6%vs 72.3%,P=0.000;35.4%vs 55.4%,P=0.015),TC、LDL-C水平明显高于男性[4.46(3.84,5.00)mmol/L vs 4.11(3.41,4.72)mmol/L,P=0.004;2.73(2.16,3.24)mmol/L vs 2.40(1.82,2.88)mmol/L,P=0.011]。女性GRACE评分中危和高危比例明显高于低危患者(67.1%vs 8.5%,30.5%vs 8.5%,P<0.01),女性与男性GRACE评分及危险分层比较,无统计学差异(P>0.05)。结论老年女性INOCA患者较男性临床症状多样、不典型,出现胸痛比例更低,TC、LDL-C水平更高,外周动脉粥样硬化发生率更低。Objective To investigate the clinical characteristics of elderly female patients with ischemia with no obstructive coronary artery disease(INOCA).Methods The clinical data of 147 elderly INOCA patients,including 82 females(55.8%)and 65 males(44.2%)in our hospital,were retrospectively analyzed.The risk of INOCA was stratified according the GRACE score.Results The incidence of chest pain and peripheral atherosclerosis and the ratio of smokers were significantly lower while the serum levels of TC and LDL-C were significantly higher in elderly female patients with INOCA than in male patients with INOCA[56.1%vs 73.8%,P=0.026;14.6%vs 72.3%,P=0.000;35.4%vs 55.4%,P=0.015;4.46(3.84,5.00)mmol/L vs 4.11(3.41,4.72)mmol/L,P=0.004;2.73(2.16,3.24)mmol/L vs 2.40(1.82,2.88)mmol/L,P=0.011].The GRACE score of females with a moderate and high risk ratio of INOCA was significantly lower than that of females with a low risk ratio of INOCA(67.1%vs 8.5%,30.5%vs 8.5%,P<0.01).No significant difference was detected in GRACE score and risk stratification between elderly female and male patients(P>0.05).Conclusion The clinical symptoms are significantly more and atypical,the incidence of chest pain and peripheral atherosclerosis is significantly lower,the serum levels of TC and LDL-C are significantly higher in female patients with INOCA than in male patients with INOCA.

关 键 词：冠状动脉疾病 胸痛 女性 胆固醇 LDL 

分 类 号：R541.4[医药卫生—心血管疾病]