农村女性冠心病患者相关危险因素及临床特征

目的 了解农村女性冠心病患者危险因素及临床特征.方法 纳入农村地区2009年6月～2011年6月冠心病患者380例,其中女性200例（观察组）,男性180例（对照组）,记录两组患者血压、血糖、血脂、吸烟等危险因素.在入组后3个月、6个月和12个月时通过门诊或电话随访,记录血压、血糖、血脂、吸烟等危险因素和用药情况,并统计随访期间发生的主要心脏不良事件（MACE,包括心功能不全、心绞痛及心肌梗死）,比较不同性别之间的差异.结果 与男性相比,女性患冠心病的发病时间更晚[（67.11±7.98）岁 vs.（56.49±8.28）岁],高血压比例更高,但吸烟比例较低;随访期间女性药物使用率低于男性,经过治疗后女性仅收缩压较基线水平有所下降（P＜0.05）,且女性MACE事件发生率更高,与男性有统计学差异（P＜0.05）.结论 与农村男性相比,女性冠心病患者发病较晚,但合并代谢异常的比例较高,而治疗率较低,预后更差.

Risk factors, therapeutic intervention and prognosis in woman patients with coronary heart disease in rural areas

Objective To investigate the risk factors and clinical characteristics of woman patients with coronary heart disease （ CHD ） in rural areas. Methods CHD patients （ n=380 ） were chosen from rural areas from Jun. 2009 to Jun. 2011, among them there were 200 female patients （observation group ） and 180 male patients （ control group ） . The risk factors were recorded including blood pressure （ BP ） , plasma glucose, blood fat and smoking. These risk factors and medicine administration were recorded through outpatient service and telephone follow-up after 3 months, 6 months and 12 months after group-dividing, and the incidence of major adverse cardiovascular events （ MACE, including cardiac insufficiency, angina and myocardial infarction ） were counted during follow-up period. All data was compared between two groups. Results Compared with male patients, female patients had the later time of CHD attack [ （ 67.11 ±7.98 ） years old vs. （ 56.49 ± 8.28 ） years old], and they had more risk factors related to metabolism but smoking proportion was lower. During follow-up period, the rate of medicine administration was lower in female patients than that in male patients. After treatment, systolic blood pressure was lower than baseline （ P〈0.05 ） , incidence of MACE was higher （ P〈O.05 ） and changes of other indexes were not significant in female patients compared with male patients. Conclusion Compared with male patients in rural areas, female patients had the later time of CHD attack, higher proportion of abnormal metabolism, lower cured rate and poorer prognosis.