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湖北恩施土家族地区女性急性心肌梗死患者临床特点及预后

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第5期
页码:
736-738
栏目:
临床研究
出版日期:
2010-06-22

文章信息/Info

Title:
Clinical characteristics and prognosis of female patients with acute myocardial infarction in Enshi area of Hubei Province
作者:
张宏伟; 李元红; 向辉华; 及新; 许虹
恩施自治州中心医院心内科，湖北 恩施 445000
Author(s):
ZHANG Hong-wei;  LI Yuan-hong;  XIANG Hui-hua;  Ji Xin;  XU Hong
Department of Cardiology, Central Hospital, Enshi Autonomy State, Enshi 445000, Hubei, China
关键词:
女性; 心肌梗死; 急性; 临床特点; 预后
Keywords:
female;  acute myocardial infarction;  clinical characteristics;  prognosis
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的: 分析女性急性心肌梗死(AMI)患者的临床特点，治疗情况及预后。方法: 入选2001～2008年恩施土家族地区AMI患者女性154例，男性462例进行回顾性研究，比较两组吸烟、高血压病、糖尿病、血脂异常、体质量指数(BMI)、阳性家族史、抑郁、典型胸痛症状、治疗情况、并发症及预后的差异。结果: 经多因素条件logistic回归分析，女性AMI患者中年龄、高脂血症、BMI>25 kg/m2、抑郁、不典型胸痛症状、并发症发生率明显高于男性，有效治疗率明显低于男性，女性AMI患者预后明显差于男性（P<0.05，P<0.01）；女性AMI患者中吸烟，典型缺血性胸痛症状明显低于男性（P<0.01）;高血压病，阳性家族史，糖尿病两者的差异无统计学意义。 结论: 恩施土家族地区女性AMI危险因素是高脂血症、BMI、抑郁；临床症状不典型，就诊时间延误没得到及时有效的治疗导致并发症发生率高、预后差的重要因素。
Abstract:
AIM: To study the clinical characteristics, therapeutic approaches and prognosis in female patients with acute myocardial infarction (AMI) in Enshi area of Hubei Province during 2001-2008. METHODS: Data compared between 154 female AMI patients and 462 male AMI patients included the following variables: age, smoking history, hypertension, diabetes, hyperlipidemia, body mass index (BMI), positive family history, depression, clinical characteristics of chest pain, therapeutic approaches, complications and prognosis. RESULTS: Multivariate logistic regression analysis showed that the factors of age, hyperlipidemia, BMI >25 kg/m2, depression, atypical chest pains and complications were significantly higher in female patients compared with those in male patients (P<0.05, P<0.01). Effective therapy and prognosis were significantly lower in female patients (P<0.01), but no significant difference was observed in the incidence of hypertension, diabetes and positive family history between genders. CONCLUSION: Hyperlipidemia, high BMI and depression are the main AMI risk factors for female patients in Enshi area of Hubei Province. Atypical symptoms, delay of hospital visit and not seeking timely and effective treatment are responsible factors for the high incidence of complications and poor prognosis.

参考文献/References

［1］蒋四亮，季小平，王勇，等. 性别对急性心肌梗死患者住院预后的影响［J］. 中华心血管病杂志, 2008, 36(7):590-593.

［2］中华医学会心血管病分会，中华心血管病杂志编辑委员会，中国循环杂志编辑委员会.急性心肌梗死诊断和治疗指南［J］. 中华心血管病杂志， 2001， 29(12)：710-725.

［3］Griffith D, Hamilton K, Norrie J, et al. Early and late mortality after myocardial infarction in men and wemen: prospective observational study［J］. Heart, 2005, 91(3):305-307.

［4］Rajala MW, Scherer PE. Miniereview: The adipocyte--at the crossroads of energy homeostasis, inflammation,andatherosclerosis［J］. Endocrinology, 2003, 144(9):3765-3773.

［5］Ruiz-Bailen M, Aguayo de Hoyos E, Ramos-Cuadra JA, et al. Influence of age on clinical course,management and mortality of acute myocardial infarction in the Spanish population［J］. Int J Cardiol, 2002, 85(2-3):285-296.

备注/Memo

备注/Memo:
收稿日期：2009-05-23.作者简介：张宏伟，副主任医师Email:zhwei1221@163.com
更新日期/Last Update: 2010-06-22