直接经皮冠状动脉介入治疗早发急性STEMI患者的性别差异

目的：探讨直接经皮冠状动脉介入治疗早发急性ST 段抬高型心肌梗死（ST-segment elevation myocardial infarction,STEMI）患者的性别差异。方法：以2018 年09 月01 日~2019 年12 月31 日就诊于河北省人民医院心血管内科行直接经皮冠状动脉介入（percutaneous coronary intervention,PCI）治疗的早发急性STEMI 患者116 例为研究对象,其中男性组95 例,女性组21 例。收集并分析2 组患者各项临床资料、手术资料、检查指标及住院期间并发症情况,评价其是否存在差异。结果：与男性组相比,女性组年龄更大,GRACE 评分、CRUSADE 评分、2 型糖尿病比例、高密度脂蛋白胆固醇（high density lipoprotein cholesterol,HDL-C）、空腹血糖（fasting blood glucose,GLU）水平及院内不良心血管事件（major adverse cardiovascular events,MACE）风险更高,血红蛋白、肾小球滤过率（glomerular filtration rate,eGFR）及尿酸水平更低,入院至球囊扩张（door-to-balloon,D2B）时间及平均住院日更长（P<0.05）;男性组支架直径及吸烟史比例均高于女性组（P<0.05）。结论：在行直接经皮冠状动脉介入治疗的早发急性STEMI 患者中,女性患者发生院内不良心血管事件风险更高,死亡率更高。

Gender Differences and Characteristics of Coronary Artery Disease in Patients with Early Onset Acute STEMI Treated by Direct PCI

Objective：To investigate the gender difference of direct percutaneous coronary intervention in patients with early-onset acute ST-segment elevation myocardial infarction（STEMI）. Methods：A total of 116 patients with early-onset acute STEMI who received direct PCI in the Department of Cardiovascular Medicine,Hebei General Hospital from September 01,2018 to December 31,2019 were selected as the study subjects,including 95 male patients and 21female patients. The clinical data,surgical data,examination indicators and complications during hospitalization of 2 groups were collected and analyzed,and the differences were evaluated. Results：Compared with the male group,the female group was older,with higher score of GRACE and CRUSADE,higher ratio of type 2 diabetes,higher level of HDL-C and GLU,and higher risk of nosocomial adverse cardiovascular events （MACE）,lower levels of hemoglobin,eGFR,and uric acid,and longer time from admission to balloon dilation （D2B time） and average length of hospital stay（ P<0.05）. The proportions of stent diameter and smoking history in male group were higher than those in female group （P<0.05）. Conclusion：Among patients with premature acute STEMI undergoing direct percutaneous coronary intervention,female patients were at higher risk of nosocomial adverse cardiovascular events and mortality.