女性早发冠心病病人危险因素的研究

目的研究女性早发冠心病病人发病的危险因素和冠脉病变特点。方法选取2015年6月至2018年6月住院治疗并经冠脉造影确诊的女性早发冠心病病人66例（发病年龄≤65岁）作为早发组，选取年龄与病例组匹配的健康女性42名作为健康对照组，选取同时期确诊的女性晚发冠心病病人70例作为晚发对照组（发病年龄 > 65岁）。对各组间一般资料、疾病史、生化指标等进行对比。结果早发组冠心病病人的吸烟史（21.2%）和高血压病史（45.5%）比例均高于健康对照组（4.8%，9.5%）和晚发对照组（11.4%，35.7%）（P < 0.05~P < 0.01）；早发组病人尿素氮、总胆固醇、低密度脂蛋白、脂蛋白、三酰甘油、乳酸脱氢酶、肌酸激酶水平与健康对照组比较明显升高（P < 0.05~P < 0.01）。与晚发对照组比较，早发组肌酐水平较低（P < 0.01），而尿素氮、脂蛋白、低密度脂蛋白、乳酸脱氢酶、肌酸激酶水平较高（P < 0.05~P < 0.01）。结论吸烟、高血压病史、尿素氮、脂蛋白、低密度脂蛋白、乳酸脱氢酶、肌酸激酶等生化指标异常升高可能是女性冠心病发病提前的危险因素，此外总胆固醇、三酰甘油水平异常升高还可能是中青年女性冠心病发生的危险因素。

Study on the risk factors of early-onset coronary heart disease in female

ObjectiveTo study the risk factors of early-onset coronary heart disease in female and characteristics of coronary artery lesion.MethodsA total of 66 women(age of onset ≤ 65 years) with early-onset coronary heart disease diagnosed by coronary angiography, 42 healthy women, and 70 late-onset coronary heart disease women(age of onset > 65 years) from June 2015 to June 2018 were divided into the early-onset group, control group and late-onset group, respectively.The general information, disease history, and biochemical indicators among three groups were compared.ResultsThe positive rate of smoking history and hypertension history in early-onset group(21.2% and 45.5%) were higher than those in control group(4.8% and 9.5%) and late-onset group(11.4% and 35.7%)(P < 0.05 to P < 0.01).The levels of urea nitrogen, total cholesterol, low density lipoprotein, lipoprotein, triglyceride, lactate dehydrogenase and creatine kinase in early-onset group were significantly higher than those in the healthy control group(P < 0.05 to P < 0.01).Compared with the late-onset group, the level of creatinine was lower(P < 0.01), while the levels of urea nitrogen, lipoprotein, low-density lipoprotein, lactate dehydrogenase and creatine kinase were higher in arly-onset group(P < 0.05 to P < 0.01).ConclusionsThe smoking, hypertension history, and abnormal levels of blood urea nitrogen, lipoprotein, low density lipoprotein, lactate dehydrogenase and creatine kinase may be the risk factors for early-onset of coronary heart disease in women.The abnormal increasing of total cholesterol and triglyceride levels may be the risk factors of coronary heart disease in middle-aged and young women.