X综合征女性患者电子束CT测定冠状动脉钙化的临床特点

为探讨X综合征女性患者冠状动脉钙化及临床情况 ,利用电子束CT对 2 6例X综合征女性患者和 2 2例冠状动脉造影及运动试验均正常的女性胸痛者冠状动脉进行检测 ,同时对其冠心病危险因子进行评估 ,测定血脂和血浆氧化型低密度脂蛋白水平 ,对比不同病例的冠状动脉钙化积分及病变血管支数。结果发现 ,有 19例(73% )X综合征女性患者存在冠状动脉钙化 ,而正常组中仅 4例 (18% )存在冠状动脉钙化 ;有冠状动脉钙化的X综合征女性患者冠心病危险因子明显高于正常组 (1.8± 1.3比 1.1± 0 .9,P <0 .0 5 ) ,前者的血浆氧化型低密度脂蛋白浓度也明显高于后者 (5 2 .38± 6 .89比 39.92± 7.87,P <0 .0 5 ) ;其中 13例为绝经期患者。绝经后X综合征患者冠状动脉钙化积分和有冠状动脉钙化的血管支数与非绝经期者相比无明显差异 ,但这两组均较正常组明显增高 (P<0 .0 5 )。结果提示 ,有相当数量的X综合征女性患者存在冠状动脉钙化 ,这种钙化似乎与绝经与否无关 ,有必要对这类患者的临床资料进行评估并作相应治疗

Clinical Characteristics of Coronary Artery Calcification Detected by Electron-Beam Computed Tomography in Women with Syndrome X

Aim To investigate the clinical characteristics of coronary artery calcification (CAC) detected by electron beam computed tomography (EBCT) in female patients with syndrome X. Methods In 26 consecutive patients with syndrome X (abnormal exercise test results and angiographically normal coronary arteries) and 22 normal group women (normal exercise test and angiographically normal coronary arteries) with chest pain, EBCT was performed. Meanwhile, the concentration of serum lipid and plasma oxidized low density lipoprotein (ox LDL) was detected; the risk factors of coronary artery disease were evaluated as well. Results The prevalence of coronary calcification in the syndrome X group was 73% (19 in 26 patients) compared with 18% (4 in 22 patients) in the normal group (p<0.05). The mean risk factors of coronary artery disease in the women with syndrome X and positive CAC were greater than those of the normal group (1.8±1.3 vs. 1.1±0.9, p<0.05), while the concentration of plasma ox LDL was higher too (52.38±6.89 vs. 39.92±7.87, p<0.05). However, the mean CAC score of the syndrome X group with positive CAC was greater than the normal ones with positive CAC, and the number of calcification was much greater, despite postmenopausal or not menopausal. Conclusions EBCT may be useful in detection of atherosclerosis in women with syndrome X who demonstrate normal coronary arteries at angiography. Careful evaluation and necessary therapy should be done in women with syndrome X and positive CAC.