危险因素对绝经后女性冠心病及冠状动脉病变的影响

目的探讨绝经后女性冠心病患者中心血管相关危险因素对冠脉疾病发生及病变程度的影响。方法入选因胸痛、胸闷拟诊冠心病行冠状动脉造影的绝经后女性患者453例。根据冠状动脉造影结果分为冠心病组（340例）和非冠心病组（113例），对2组患者的临床特点及冠状动脉病变特点进行统计学比较。结果①冠心病组和非冠心病组间年龄、收缩压、舒张压、脉压、TG、TC及LDL—C水平差异有统计学意义[（63±8）岁比（60±9）岁，（149±28）mmHg（1mmbig=0．133kPa）比（128±14）mmHg，（88±16）mmHg比（78±8）mnlHg，（61±22）mmHg比（50±12）mmHg，（2．2±1．2）mmol／L比（1．8±1．0）mmol／L，（4．6±1．7）mmol／L比（4．8±1．0）mmol／L，（3．1±0．8）mmol／L比（2．1±0．8）mmol／L；均P〈0．05]。②多因素回归分析显示，收缩压、脉压、TG、LDL—C为女性冠心病的独立危险因素（P〈0．05）。相关危险度依次为TG、LDL—C、脉压、收缩压。③340例冠心病患者中，单支病变者103例，2支病变者114例，3支病变者123例。冠状动脉病变1、2、3支数者间年龄、LDL—C差异有统计学意义[年龄：（61±8）、（62±8）、（64±8）岁；LDL—C：（2．9±0．7）、（3．0±0．7）、（3．2±0．8）mmol／L；均P〈0．05]。结论心血管危险因素在女性绝经后冠心病的发生和发展中起重要作用，有效地对危险因素进行控制是开展女性冠心病一级预防的关键。

Correlation between cardiovascular risk factors and coronary artery lesion in postmenopausal women with coronary heart disease

Objective To explore the effect of cardiac risk factors on the severity of coronary artery lesion in post menopausal women with coronary heart disease（CHD）. Methods The study prospectively analyzed the post manopasual femal patients from 2012.9 to 2013.2 who were admitted for chest pain, chest tightness and got coronary angiography. According to the results of coronary angiography, the patients were divided into the CHD group （ 340 cases） and non-CHD group （ 113 cases）. Results ①Single-variant analysis showed age, systolic blood pressure, diastolic blood pressure, pulse pressure, triglycerides, total cholesterol, low-density lipoprotein cholesterol （LDL-C） and risk factors had statistically significant difference between CHD group and non- CHD group [ （63 ± 8）old years vs （60 ±9） old years,（149 ±28）mm Hg（1 mm Hg =0. 133 kPa） vs （128 ± 14）mm Hg,（88±16）mm Hg vs （78 ±8）mm Hg,（61 ±22）mmHg vs （50 ± 12）mm Hg,（2.2 ±1.2）mmol/L vs （1.8 ±1.0）mmol/L, （ 4.6 ±1.7 ） mmol/L vs （4.8± 1.0 ） mmol/L, （ 3.1 ± 0.8 ） mmol/L vs （ 2.1 ±0.8 ） mmol/L ; all P 〈 0.05 ]. ②The muhivariant logistic regression analysis showed systolic blood pressure, pulse pressure, triglyceride and LDL-C as an independent risk factors for women with CHD（ P 〈 0.05 ）. Associated risk were as follows： triglycerides, LDL-C, pulse pressure, systolic blood pressure. ③Aeeording to the degree of coronary artery disease, the coronary group patients were divided into single-vessel disease group （103 cases,. 30.3% ）, 2-vessel disease group （114 cases, 33.5% ） , 3-vessel disease group （ 123 cases, 36.2% ）. Age and LDL-C in coronary artery disease were significantly different among different groups [ age ： （ 61 ± 8 ）, （ 62 ± 8 ）, （ 64 ± 8 ） old years ; LDL-C ： （ 2.9 ± 0.7 ）, （ 3.0 ± 0.7 ）, （ 3.2 ± 0.8 ） mmol/L ; all P 〈 0.05 ]. Conclusion Cardiovascular risk factors plays an important role in postmenopansal women with CHD; effectively controlling these risk factors is the key to prevention of CHD.