中国急性心肌梗死患者心血管危险因素的性别差异分析  

Gender differences in cardiovascular risk factors in patients with acute myocardial infarction in China

作　　者：张旻 高晓津[1] 杨进刚[2] 苏淑红[3] 杨跃进[4] 许海燕[4] 冯媛媛 宋雷[4] 吴元[4] 张峻[4] 胡奉环[4] 乔树宾[4] 李卫[2] 伏蕊 孙慧 董秋婷[4] 严欣欣 张璇[4] 叶蕴青[4] 金辰[4] Zhang Min;Gao Xiaojin;Yang Jingang;Su Shuhong;Yang Yuejin;Xu Haiyan;Feng Yuanyuan;Song Lei;Wu Yuan;Zhang Jun;Hu Fenghuan;Qiao Shubin;Li Wei;Fu Rui;Sun Hui;Dong Qiuting;Yan Xinxin;Zhang Xuan;Ye Yunqing;Jin Chen(Department of Cardiovascular Disease,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medial Sciences and Peking Union Medical College,Beijing 100037,China;State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medial Sciences and Peking Union Medical College,Beijing 100037,China;Department of Cardiology,Xinxiang Central Hospital,Xinxiang 453000,China;Coronary Heart Disease Center,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medial Sciences and Peking Union Medical College,Beijing 100037,China)

机构地区：[1]北京协和医学院,国家心血管病中心,中国医学科学院阜外医院心血管内科,100037 [2]北京协和医学院,国家心血管病中心中,国医学科学院阜外医院心血管疾病国家重点实验室,100037 [3]新乡市中心医院心血管综合病区,新乡453000 [4]北京协和医学院,国家心血管病中心,中国医学科学院阜外医院冠心病中心,100037

出　　处：《中华医学杂志》2021年第44期3643-3649,共7页National Medical Journal of China

基　　金：国家科技支撑计划(2011BAI11B02)。

摘　　要：目的了解中国急性心肌梗死(AMI)患者心血管危险因素的性别差异。方法以2013年1月1日至2014年9月30日中国31个省份107家医院的26592例AMI患者为对象,采用自制问卷收集患者年龄、性别、身高、体重、AMI类型、心脑血管病史、用药史、生活方式和AMI危险因素[包括高血压、糖尿病、血脂异常、超重和(或)肥胖、吸烟和早发冠心病家族史等]资料,将具有完整危险因素信息的24394例患者纳入研究,分析AMI患者心血管危险因素的性别差异。结果患者年龄为(62.2±13.8)岁,其中男性18162例(74.5%),ST段抬高型心肌梗死(STEMI)18209例(74.6%)。男性患者年龄为(60.2±13.7)岁,低于女性[(68.2±12.3)岁];体质指数为(24.2±3.0)kg/m^(2),高于女性[(23.8±3.4)kg/m^(2)];超重和(或)肥胖、吸烟、血脂异常、早发冠心病家族史、肥腻饮食和AMI病史比例分别为51.8%、55.2%、7.2%、3.8%、80.4%和7.7%,均高于女性(分别为45.9%、9.9%、5.8%、2.3%、65.0%和5.9%);高血压、糖尿病、缺乏运动和卒中病史比例分别为46.5%、17.2%、77.8%和8.5%,均低于女性(分别为61.4%、24.8%、81.7%和11.1%);均P<0.05。男性和女性患者外周血管病史的比例分别为0.6%和0.7%,差异无统计学意义(P>0.05)。亚组分析显示:有别于对全部患者的分析结果,非ST段抬高型心肌梗死组血脂异常比例、青年和中年组早发冠心病家族史比例、老年组超重和(或)肥胖、缺乏运动比例性别差异均无统计学意义(均P>0.05)。结论中国AMI患者心血管危险因素存在性别差异,高血压和糖尿病更常见于女性患者,超重和(或)肥胖、肥腻饮食和吸烟等更常见于男性患者。Objective To understand gender differences of cardiovascular risk factors in patients with acute myocardial infarction(AMI)in China.Methods A total of 26592 patients with AMI from 107 hospitals in 31 provinces in China from January 1,2013 to September 30,2014 were included.Self‐designed questionnaire was used to collect patients′age,gender,height,weight,type of AMI,medical history of cardiovascular and cerebrovascular diseases,medication history,lifestyle and AMI risk factors,including high blood pressure,diabetes,dyslipidemia,overweight and/or obesity,smoking history and family history of early onset coronary artery disease.A total of 24394 patients with complete clinical data were included in the analysis,and gender differences in cardiovascular risk factors were analyzed in all and subgroups with different characteristics.Results The patients were(62.2±13.8)years old,including 18162(74.5%)males and 18209(74.6%)ST‐segment elevation myocardial infarction(STEMI).The age of male patients was(60.2±13.7)years,which was younger than that of female patients[(68.2±12.3)years].The body mass index of male patients was(24.2±3.0)kg/m^(2),which was higher than that of female patients[(23.8±3.4)kg/m^(2)].The proportions of patients with overweight and/or obesity,smoking history,dyslipidemia,family history of early onset coronary heart disease,fatty diet and history of AMI were 51.8%,55.2%,7.2%,3.8%,80.4%and 7.7%,which were higher than those of females(45.9%,9.9%,5.8%,2.3%,65.0%and 5.9%,respectively).The proportions of hypertension,diabetes,physical inactivity and stroke history were 46.5%,17.2%,77.8%and 8.5%,respectively,which were lower than those in female patients[61.4%(3829 cases),24.8%,81.7%and 11.1%,respectively](all P values<0.05).The proportions of peripheral vascular diseases history in male and female patients were 0.6%and 0.7%,respectively,with no statistical significance in difference(P>0.05).Subgroup analysis showed inconsistent results comparing to analysis of all patients:there were no statistical s

关 键 词：心肌梗塞 危险因素 性别因素 年龄分布 横断面研究 

分 类 号：R542.22[医药卫生—心血管疾病]