早发冠心病患者危险因素与冠状动脉病变的性别差异

目的探讨女性早发冠心病(CHD)患者的心血管危险因素和冠状动脉病变特点。方法纳入753例经冠状动脉造影确诊为早发CHD(男性<55岁,女性<65岁)患者,对男性组(507例)和女性组(246例)的3个常见心血管危险因素(糖尿病、血脂异常及高血压)和冠状动脉病变特点进行对比分析。结果早发CHD男性组和女性组平均年龄相近,女性组糖尿病患者比例显著高于男性组(33.74%vs19.13%,P<0.001),而高血压、血脂异常差异无显著意义(P>0.05)。早发CHD单支病变占49.14%,部位以前降支为主(70.65%),但2组冠状动脉造影结果比较,无论是狭窄程度、狭窄支数还是累及分支血管比例差异均无显著意义(P均>0.05)。2组左心室射血分数(LVEF)和左心室舒张末压(LVEDP)比较,差异无显著意义(P>0.05)。结论女性早发CHD冠状动脉病变并不轻于男性,对女性早发CHD应予重视;临床诊断女性早发CHD应强调危险因素的综合评估。

Gender gap in risk factors and coronary features in patients with premature coronary heart disease

Objective To characterize the clinical profiles, risk factors and coronary artery lesion in women with premature coronary heart disease(CHD).Methods A total of 753 patients with premature CHD were divided into female group (<65 years,n=246) and male group (<55 years,n=507),their risk factors including diabetes, dyslipidemia and hypertension, and coronary characteristics were compared.Results Compared with the male group, the female group with premature CHD had a similar age, a higher prevalence of diabetes (33.74% vs 19.13%,P< 0.001 ).There were no significant differences in the prevalence of dyslipidemia, hypertension and the number of risk factors. Myocardial infarction (MI) was more prevalent among women (37.40% vs 28.20%,P<0.05).The patients with single branch stenosis accounted for 49.14%.The incidence of left anterior descending branch (LAD) stenosis was 70.65%.Two groups showed no significant differences in angiographic findings in terms of involved branches, the location and the severity of coronary lesion,the LVEF and the LVEDP (P>0.05).Conclusion The coronary artery lesion in females are not less than that in males.The comprehensive assessment of risk factors is important in the accurate diagnosis of female premature CHD.