绝经期前、后女性急性心肌梗死患者临床特点及危险因素

目的:探讨绝经期前、后女性急性心肌梗死(acutem yocardial infarction,AMI)患者的危险因素、发病特点、预后。方法:2007年1月～2011年1月北华大学附属医院收治的女性AMI患者310例,依据是否绝经及绝经年限分组并对危险因素、临床表现、并发症和入院30天病死率进行比较。结果:绝经前女性AMI患者与绝经后患者相比,高脂血症的发生率更低(OR=8.151,P=0.005);典型胸痛症状的发生与年龄(OR=0.881,P=0.001)及绝经年限(OR=2.600,P=0.025)差异有统计学意义;绝经年限与严重心律失常和心力衰竭(>KillipⅡ级)差异无统计学意义(P>0.05)。合并糖尿病和心力衰竭(>KillipⅡ级)是预测绝经后女性心肌梗死患者死亡率的独立危险因素(OR=1.081,P=0.043;OR=12.339,P<0.001)。结论:绝经期前、后女性心肌梗死患者具有不同的临床特点,应结合其临床特点,采取不同的预防和诊疗措施。

Clinical characteristics and risk factors of acute myocardial infarction among the premenopausal and postmenopausal female patients

Objective:To explore the risk factors,characteristics,and prognosis of acute myocardial infarction(AMI) among the premenopausal and postmenopausal female patients.Methods:Three hundred and ten female patients with AMI who were treated in the hospital from January 2007 to January 2011 were divided into different groups according to menopause or not and the duration of menopause,then the risk factors,clinical manifestations,complications,and the fatality rates on thirtieth day after admission to hospital in different groups were compared.Results:The incidence of hyperlipidemia in premenopausal AMI female patients was significantly lower than that in postmenopausal AMI female patients(OR=8.151,P=0.005);there was statistically significant difference in the incidence of typical chest pain symptom among the female patients of different age groups(OR=0.881,P= 0.001) and different durations of menopause(OR=2.600,P=0.025);there was no statistically significant difference in the incidences of severe arrhythmia and heart failure(>KillipⅡ grade) among the female patients of different durations of menopause(P>0.05).Diabetes mellitus combined with heart failure was an independent risk factor to predict fatality rate of postmenopausal AMI female patients(OR=1.081,P=0.043;OR=12.339,P<0.001).Conclusion:The premenopausal and postmenopausal female patients with AMI have different clinical characteristics,different preventive and therapeutic measures should be adopted according to the clinical characteristics.