围绝经期妇女冠心病的临床诊断特点

目的:探讨围绝经期妇女冠心病的临床诊断特点.方法:回顾性分析180例(围绝经期组76例,绝经后组104例)临床疑为冠心病行冠状动脉(冠脉)造影检查患者的临床资料,比较冠心病危险因素、临床胸痛特点以及心电图、动态心电图、冠脉造影在冠心病诊断中的价值.结果:围绝经期组患者冠心病发生率为13.5%(10/76),明显低于绝经后组的43.3%(45/104,P<0.01);围绝经期妇女冠心病患者有绝经、高血压、危险因素≥2个的发生率明显高于非冠心病患者(P<0.01,P<0.05);围绝经期患者胸痛多为不典型心绞痛;围绝经组平静心电图和动态心电图的敏感性为50.0%和60.0%,特异性为62.1%和59.1%.结论:围绝经期妇女冠心病的临床诊断要慎重,心电图、动态心电图的诊断价值受到一定限制;冠脉造影是冠心病的确诊手段,但应严格掌握适应证.

Clinical diagnostic characteristics of coronary heart disease in perimenopausal women

Objective: To explore the dignositic characteristics of coronary heart disease (CHD) in perimenopausal women. Methods: The clinical data of 180 patients suspected of CHD were retrospectively analyzed. The risk factors of CHD,clinical characteristics of chest pain, routine electrocardiography,ambulatory electrocardiography and coronary artery angiography (CAA) were compared between perimenopause group and control group. Results: The incidence of CHD increased significantly in control group(13.5%, 10/76) compared to perimenopause group (43.3%, 45/104, P <0.01) and the possibility of CHD was higher in women with menopause and hypertension, and more than 2 risk factors of CHD( P <0.01, P <0.05). The sensitivity and specificity of routine and ambulatory electrocardiography were 50.0% and 60.0%,62.1% and 59.1% respectively. The chest pain was mainly atypical angina. Conclusion: The clincical diagnosis of CHD in perimenopausal women should be prudent; the diagnostic vaule of routine and ambulatory electrocardiography is limited. CAA is a definite diagnosis for CHD, but the indications of CAA should be strictly controlled.