中老年女性冠心病危险因素和冠状动脉病变特点研究

目的 探讨50岁以上各年龄段女性冠状动脉粥样硬化性心脏病（冠心病）患者危险因素和冠状动脉病变的特点.方法 回顾性分析126例行冠状动脉造影的女性冠心病患者的临床资料,根据年龄分为3组：G1组（50～60岁）,G2组（61～70岁）,G3组（＞70岁）,观察各组既往病史、生化指标与冠心病发病的关系,分析各组冠状动脉病变的特点.结果（1）从G1组到G3组,原发性高血压（高血压）患病率分别为41.4％、62.3％、68.2％,逐渐升高;入院时收缩压为（129.2±22.4）mm Hg（1 mm Hg=0.133 kPa）、（133.7±18.6）mm Hg、（140.8±21.4）mm Hg,G3组与G1组比较差异有统计学意义（P＜0.05）.（2）G1、G2组单支血管病变发生率较高为48.5％、56.6％;G3组三支血管病变发生率较高为45.5％,与G1、G2组相比,差异有统计学意义（P＜0.05）.（3）改良Gensini评分3组分别为（6.6±3.1）分、（7.3±3.0）分、（7.7±3.0）分,3组比较差异无统计学意义（P＞0.05）.结论 高血压病史和收缩压高为中老年女性冠心病患者的独立危险因素;70岁以下女性冠心病患者病变以单支血管病变为主,70岁以上女性冠心病患者以三支血管病变更为多见,并且随着年龄增加,冠状动脉病变程度逐渐加重.

Risk factors and coronary artery lesions profile of coronary artery disease in middle-aged and old women

Objectives To investigate the risk factors and coronary artery lesions characteristics of coronary artery disease （CAD） in middle-aged and old women over 50 years of age.Methods Data of 126 women with CAD who underwent coronary angiography were retrospectively analyzed.They were divided into three groups according to the age：group G1 （50-60 years old）,group G2 （61-70）,group G3 （over 70 years old）.Relationship of medical history,biochemical indexes and onset of coronary heart disease was observed among the three groups.Characteristics of coronary artery lesions were analyzed.Results （1） FromG1toG3,hypertension prevalence rates were 41.4%,62.3%,68.2%respectively and increased gradually.Systolic blood pressures on admission were （129.2±22.4） mm Hg （1 mm Hg=0.133kPa）,（133.7 ± 18.6） mm Hg and （140.8 ±21.4） mm Hg respectively ; Systolic blood pressure in G3 was significantly higher than that in G1 （P〈0.05）.（2）Incidences of single-vessel disease were higher in G1 and G2,which were 48.5%and 56.6% respectively; Incidence of three-vessel disease was 45.5% in G3,which had significant difference compared with those in G1 and G2 （P〈0.05）.（3）Improved Gensini scores were 6.6±3.1,7.3±3.0,7.7±3.0 in the three groups respectively,and there were no significant differences （P〉0.05）.Conclusions History of hypertension and high systolic blood pressure are independent risk factors for coronary heart disease in middle-aged and elderly women.Women with CAD under 70 years old are mainly with single-vessel disease,and women with CAD over 70 are mainly with three-vessel disease.Severity of CAD gradually increases with age.