女性急性冠脉综合征特点分析

目的探讨女性急性冠脉综合征（ACS）患者的临床及冠脉病变特点。方法对因胸痛、胸闷而疑诊为ACS住院的750例患者，经冠脉造影（CAG）确诊为ACS的患者580例，进行回顾分析对比。结果①临床上：女性组发病年龄高于男性组（74．3±4．2 vs 62．1±3．5，P〈0．001），女性ACS发病率和冠造阳性率低（18．9％vs 80．1％，P〈0．001；55．6％ vs 85．14％，P〈0．001），女性组典型心绞痛发生率明显低于男组（34．5％ vs 76．8％，P〈0．001），但男性组合并高尿酸血症明显高于女组（42．13％ vs 22．73％，P〈0．001），女组体重指数明显高于男性性组（62．73％ vs 47．02％，P〈0．001），女性组有吸烟史者显著低于男性组（12．73％ vs 68．9％，P〈0．001）。女性组合并高血压病、糖尿病者明显高于男性组（58．18％ vs 41．28％，P〈0．001；42．73％ vs 23．83％，P〈0．001）。②冠脉造影显示：女性组多支病变发生率明显高于男性组（47．27％vs 36．38％，P〈0．05），侧支循环较男组多（50．90％vs35．16％，P〈0．005），女性组血管狭窄程度以轻、中度为多（49．09％ vs 37．02％，P〈0．05），重度狭窄差异无统计学意义33．64％ vs 29．36％，P〉0．05）。女组冠脉病变以A、C型病变为多（42．73％ vs 34．68％；38．18％ vs 31．49％），但P值均〉0．05，无统计学意义。而两组病变血管分布情况无明显差异。结论女性发病率较男性低，发病年龄较男性大，女性临床症状不如男性典型，女性冠脉病变以多支病变为多，侧支循环形成较男性多，以B、C型为主，合并高血压、糖尿病、肥胖者较男性多。

The analysis of the features of acute coronary artery syndrome in women

Objective To investigate the clinical and coronary angiography(CAG) features in women with acute coronary artery syndrome (ACS).Methods 750 patients with chest pain and chest distress were suspected ACS, and in which 580 patients were diagnosed as ACS by coronary angiography(CAG). Results ①Clinically, the age at onset in female group was significantly higher than in male group(74.3±4.2 vs 62.1±3.5, P<0.001). The incidence rate of ACS and the positive result of CAG in female group were both lower than in male group(18.9% vs 80.1%,P<0.001; 55.6% vs 85.14%,P<0.001). The incidence of typical angina pectoris in female group was significantly lower than in male group(34.5% vs 76.8%, P<0.001), but the patients with hyperuricemia in male group were significantly more than in female group(42.13% vs 22.73%, P<0.001). The body mass index in female group was significantly higher than in male group (62.73% vs 47.02%, P<0.001). The number with smoking habit female group was significantly lower than in male group(12.73% vs 68.9%, P<0.001). The patients with hypertension and diabetes in female group were significantly more than in male group(58.18% vs 41.28%, P< 0.001; 42.73% vs 23.83%,P<0.001). ②CAG, the results showed that the incidence of multivessel disease and bypass circulation formation in female group were significantly higher than in male group(47.27% vs 36.38%, P<0.05; 50.90% vs 35.16%, P<0.005). The degree of vascular stenosis in female group was mild to moderate(49.09% vs 37.02%, P<0.05), but there was no significant difference in the severe stenosis between the two groups(33.64% vs 29.36%, P>0.05). Most of the female patients had a A or C type of angiostenosis(42.73% vs 34.68%; 38.18% vs 31.49%), but there was no significant difference(P>0.05). Besides, there was in no significant difference in the distribution of vascular lesions between the two groups (P>0.05).Conclusion The incidence rate of ACS in was lower than in men. The age at onset of women was higher than men,and the clinical symptom of women was not typical either. The leisons of coronary artery in women were multivessel, and bypass circulation formations were more than in male. Most of the female patients had a B or C type of angiostenosis. And the number of female patients with hypertension, diabetes and obesity was more than male patients.