老年女性冠心病的危险因素及冠状动脉病变特点

目的探讨老年女性冠心病的危险因素及冠状动脉病变的特点。方法选择冠状动脉造影术的老年女性282例（≥65岁）,分为冠心病组（n=202）和非冠心病组（n=80）,详细记录病史、体检资料,检验尿酸、雌激素、孕激素及雄激素的含量,并记录冠状动脉造影结果。结果与非冠心病组比较,冠心病组闭经年龄较早,糖尿病、高脂血症、高血压所占比例高,尿酸水平明显升高（P〈0.01）,雌二醇水平明显降低（P〈0.01）,两组间孕激素及雄激素水平差异无统计学意义（P〉0.05）;Logistic回归分析显示,尿酸水平与冠心病呈正相关,雌激素水平与冠心病呈负相关;冠心病组中受累血管支数、血管狭窄程度与危险因素数目显示有相关性（P〈0.05）。结论老年女性冠心病与糖尿病、高血压及高脂血症有关,血清雌激素降低及尿酸升高是老年女性冠心病发病的独立危险因素,冠状动脉病变严重程度与危险因素的多少有关。

Risk factors and features of coronary artery disease in elderly women with coronary heart disease

Objective To explore the risk factors and features of coronary artery disease in elderly women with coronary heart disease（CHD）.Methods Two hundred and eighty-two elderly women（≥65years old）were divided into two groups by angiographic results,CHD group（n=202）and non-CHD group（control group）（n=80）.The medical history and physical examinations of patients were recorded in detail.Blood sampling was taken for serum uric acid and serum concentrations of estradiol,progestin and testosterone.The results were compared between two groups.Results Compared with non-CHD group,the patients in CHD group were significantly younger in amenorrhea age.The proportion of diabetes mellitus,lipid metabolic disorders or hypertension were higher in CHD group and serum uric acid level also increased in CHD group（P 0.01）.Serum concentration of estradiol in CHD group was significantly lower（P 0.01）.Serum concentrations of estradiol,progestin and testosterone between two groups showed no significant differences（P 0.05）.Logistic regression analysis indicated that UA level was positively correlated with CHD,while serum estradiol level was negatively correlated with CHD.The extent of coronary artery disease was related to the number of risk factors（P 0.05）.In CHD group,the number of affected arteries,vascular stenosis were correlated with the number of risk factors.Conclusion CHD in elderly women was related to diabetes mellitus,hypertension and lipid metabolic disorders.Lower estrogen and higher serum uric acid are independent risk factors for CHD in older women.The severity of coronary lesion relates with the risk factors.