女性冠状动脉慢性完全闭塞性病变的临床特点及PCI疗效(PDF)
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2008年第3期
- 页码:
- 320-322，326
- 栏目:
- 临床研究
- 出版日期:
- 2008-05-20
文章信息/Info
- Title:
- Clinical characteristics and PCI therapy effect in female with chronic total occlusion
- Author(s):
- MAI Xiaoyan1; HAN Yaling2; GUO Liang1; JING Quanmin2; LI Yi2; ZHANG Xiaolin2
- 1.Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China; 2.Department of Cardiology, Shenyang PLA General Hospital, Shengyang Military Area Command, Shengyang 110016, Liaoning, China
- Keywords:
- coronary disease; chronic total occlusion; female
- 分类号:
- R541.4
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的 分析女性冠状动脉慢性完全闭塞性病变(CTO)的临床特点以及冠状动脉介入治疗（PCI）的疗效。方法 将2005年1月～12月CTO的连续病例，按性别分为男性和女性两组，比较两组患者一般资料、冠脉造影资料、PCI成功率以及院内并发症。结果 与男性相比，女性患者年龄大［(69±7)岁 vs (59±11)岁，P<001］，住院时间长［(11±5) d vs (8±3) d，P<001］，糖尿病，高血脂以及高血压发生率比男性多(42% vs 29%，51% vs 42%，54% vs 41%，均P<005)，心功能不全明显高于男性(31% vs 11%，P<001)，且CTO闭塞时间超过12个月比例明显高于男性(57% vs 39%，P<001)。典型心绞痛表现较男性少(58% vs 76%，P<001)，男性患者多有吸烟史和饮酒史(15% vs 47%，181% vs 32%，均P<005)。女性患者多支病变、病变残端刀切状，闭塞端≥15 mm，病变近端及病变处钙化比例均高于男性组(42% vs 20%，42% vs 29%，19% vs 10%，均P<005)。女性CTO患者行PCI术成功率低于男性组(83% vs 92%，P<001)。女性组CTO患者术后1年无主要心脑血管事件生存率（MACCE）低于男性组（P<005）。结论 女性CTO患者人群年龄偏大，易感因素多，病变特征比较复杂，手术成功率低，预后差。
- Abstract:
- AIM To analyze the clinical and angiographic characteristics of the female patients with chronic total occlusion lesions (CTO) and the success rate of percutaneous coronary intervention (PCI). METHODS A retrospective study was carried out in 72 female and 206 male patients with CTO at Shenyang PLA General Hospital from January 2005 to December 2005. RESULTS Female patients were generally older than male counterparts ［(69±7) vs (59±11), P<001］ and the average hospitalization days were longer ［(11±5) vs (8±3) d, P<001］. A higher prevalence of hypertension, hyperlipemia and diabetes mellitus were found in the female patients ［(42% vs 29%), (51% vs 42%), (54% vs 41%), P<005］. Cardiac insufficiency and the occlusion time more than 12 months were also more common in female patients ［(31% vs 11%), P<001; (57% vs 39%, P<001)］. However, the smoking and drinking history was more common in male patients ［(15% vs 47%) vs (181% vs 32%), P<005］. Male patients also had a more typical angina (58% vs 76%, P<001). CTO characteristics, including multivessel coronary disease, abrupt missing stump, length of occluded segment >15 mm, moderate to severe calcification in females were higher compared with those in male patients (42% vs 20%, 42% vs 29%, 19% vs 10%, P<005). The PCI success rate in female patients was lower than that in male patients (83% vs 922%, P<005). The survival free of MACCE in female patients were lower than that in male patients（P<005）. CONCLUSION Compared with male patients, female patients with CTO are older in age and have more risk factors. Female CTO patients have more complications The characteristics of CTO are more complicated in female patients, as a result, female patients have lower PCI therapy effect and poorer prognosis.
参考文献/References
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备注/Memo
- 备注/Memo:
- 收稿日期：2007-12-18.通讯作者：韩雅玲，主任医师，主要从事冠心病介入治疗研究Email:hanyal@mail.sy.ln.cn 作者简介：麦晓燕，硕士生Email:rainbow3180@163.com 通讯作者：韩雅玲，主任医师，主要从事冠心病介入治疗研究Email:hanyal@mail.sy.ln.cn 作者简介：麦晓燕，硕士生Email:rainbow3180@163.com
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