绝经不同时期女性冠心病的危险因素及临床特点分析

目的探讨女性冠心病患者绝经早、晚期的临床特征及危险因素。方法选取经冠状动脉造影确诊的绝经女性冠心病患者259例,其中绝经≤10年组102例,绝经10年组157例。分析2组患者的临床特征及危险因素。结果绝经≤10年组高血压发病率显著较高(P0.05),雌激素含量显著较高(P0.05);2组HLD-C、TC水平无显著差异,IMT均达到动脉硬化程度;绝经10年组中,糖尿病发病率显著较高,LDL-C含量显著较高,雌激素含量显著较低(P0.05)。绝经≤10年组冠脉血管病变以单支病变为主,而绝经10年组冠脉血管病变以双支或多支病变为主(P0.05)。多因素分析显示,2组高血压、糖尿病、甘油三酯、低密度脂蛋白胆固醇均为冠心病的危险因素,雌二醇为保护因素。结论糖尿病、高血压、甘油三酯、低密度脂蛋白胆固醇、雌激素降低都是女性冠心病独立的危险因素,绝经早期女性冠心病患者血管内皮及动脉硬化程度相对于绝经晚期患者较好,此时雌激素替代对于女性冠心病患者有益。

Risk factors of women with coronary heart disease in different postmenopausal periods and its clinical characteristics

Objective To investigate clinical characteristics and risk factors in early and advanced menopausal women with coronary heart disease (CHD).Methods A total of 259 menopausal women with CHD confirmed by coronary angiography in our hospital were selected as research objects,among whom 102 cases were in menopause≤ 10 years group,and 157 cases in menopause ＞ 10 years group.The clinical characteristics and risk factors of two groups were compared.Results The menopause ≤ 10 years group had higher incidence rate of hypertension and estrogen levels(P ＜ 0.05),but there was no significant difference in HLD-C,and TC levels,and carotid intima-media thickness (IMT) reached the degree of atherosclerosis.Menopause ＞ 10 years group showed a significantly higher incidence of diabetes,but LDL-C level and estrogen levels was significantly lower (P ＜ 0.05).The coronary artery disease in the menopause≤ 10 years group mainly occurred in single lesion,while the menopause ＞ 10 years group in double or multi-vessel lesion (P ＜0.05).Multivariate analysis showed that hypertension,diabetes,triglycerides,low-density lipoprotein cholesterol were risk factors for coronary heart disease,while estradiol was a protective factor.Conclusion Hypertension,diabetes,triglycerides,and low-density lipoprotein cholesterol and decreased estrogen are risk factors for women with coronary heart disease.Conditions of vascular endothelium and atherosclerosis of early postmenopausal women are better than the advanced postmenopausal women,and estrogen alternative is favorable for the patients.