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|本期目录/Table of Contents|

早发冠心病患者的临床特征和冠脉病变特点的性别差异分析

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2015年第6期
页码:
712-716
栏目:
临床研究
出版日期:
2015-07-15

文章信息/Info

Title:
Sex differences in clinical and coronary artery features of patients with premature coronary heart disease
作者:
王学忠; 王岳松; 汪韶君; 张先林; 方永华
(马鞍山市人民医院心内科,安徽 马鞍山 243000）
Author(s):
WANG Xue-zhong;  WANG Yue-song;  WANG Shao-jun;  ZHANG Xian-lin;  FANG Yong-hua
(Department of Cardiovascology, Peoples Hospital of Maanshan, Maanshan 243000, Anhui, China)
关键词:
冠状动脉疾病; 早发; 性别差异; 冠状动脉病变
Keywords:
coronary heart disease;  premature;  gender difference;  coronary artery lesion
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 探讨早发冠心病患者的危险因素、临床症状和冠状动脉病变特点的性别差异。方法 连续入选我科2009年5月~2014年10月经冠脉造影确诊的198例早发冠心病患者，分为男性组（年龄<55岁,n=135）和女性组（年龄<65岁,n=63）。观察两组在冠心病危险因素、临床症状和冠脉造影特点等方面的差异，探讨早发冠心病患者的性别特征。结果 男性组吸烟(83% vs. 5%，P<0.01)、肥胖(28% vs. 16%,P<0.05)和饮酒的比例(39% vs. 2%,P<0.01)显著高于女性组，而女性组高血压病患者的比例高于男性组(70% vs. 51%,P<0.05)；两组糖尿病、血脂异常患者的比例之间差别无统计学意义。男性组血清三酰甘油水平较女性组高〔(2.0±1.4) mmol/L vs.(1.6±0.9) mmol/L,P<0.05〕，而高密度脂蛋白胆固醇〔(1.03±0.23) mmol/L vs.(1.18±0.27) mmol/L,P<0.01〕和载脂蛋白A水平〔(1.11±0.19) g/L vs.(1.20±0.23) g/L,P<0.01〕和载脂蛋白A/B比值〔(1.4±0.5) vs.(1.6±0.5),P<0.01〕则均较女性组低。男性组危险因素聚集较女性组明显〔(1.9±1.0) vs.( 1.1±0.8)，P<0.01〕；职业分布中，工人在两组所占比例均较高(50% vs. 40%),但男女组间无显著差异。与男性组比较，女性下岗或无业比例较更高(12% vs. 30%,P<0.01)；两组无胸痛比例(35% vs. 46 %)无显著差异，同时，男性患者出汗较为常见(44% vs. 29%,P<0.05)，而女性组心悸现象则较多见(7% vs. 22%,P<0.01)。两组冠状动脉造影结果显示均以单支病变为主(49% vs. 60%)，病变血管均以前降支最为多见(68% vs. 54%)。两组冠状动脉造影结果比较，病变血管数、罪犯血管分布和累及植入支架比例之间差别均无统计学意义。结论 早发冠心病患者临床特征存在性别差异，但冠状动脉病变分布特征二者之间无显著差别。
Abstract:
AIM To evaluate sex differences in risk factors, clinical profiles, and coronary artery lesion in patients with premature coronary heart disease (PCHD). METHODS A total of 198 consecutive patients with premature CHD who were confirmed by coronary angiography with ≥50% luminal stenosis were divided into female group (F group, <55 years old, n=63) and male group (M group, <65 years old, n=135) from May 2009 to October 2014 in our department. Differences in CHD risk factors, clinical symptom and angiographic features between groups were observed and analyzed. RESULTS Compared to F group, the M group had a significantly higher prevalence of smoking (83 vs. 5%, P<0.01), obesity (28 vs. 16%, P<0.05), and alcohol consumption (39 vs. 2%, P<0.01); however, the F group showed a significantly higher rate of hypertension (70 vs. 51%, P<0.05). There were no significant differences in the prevalence rates of dyslipidemia, diabetes and number of risk factors between groups. M group shows a higher mean of serum triglycerides ［(2.0±1.4) mmol/L vs. (1.6±0.9) mmol/L, P<0.05］ and lower serum high-density lipoprotein cholesterol (HDL) cholesterol levels ［(1.03±0.23) mmol/L vs.(1.18±0.27) mmol/L, P<0.01］, lower apolipoprotein A ［(1.11±0.19) g/L vs.(1.20±0.23) g/L, P<0.01］, and apolipoprotein A/B ratio ［(1.4±0.5) vs.(1.6 ± 0.5), P<0.01］ than the F group. Traditional cardiovascular risk factor clustering in the M group is higher than in the F group ［(1.9±1.0) vs.(1.1 ± 0.8), P<0.01］. Laborers were the most common occupation in the two groups (50 vs. 40%); whereas the F group had a higher proportion of unemployment (12% vs. 30%, P<0.01). Absence of chest pain was noted commonly in the two groups (35 vs. 46%) but without differences between groups. Palpitations were the most frequent symptom in the F group (7 vs. 22%, P<0.01); however, the phenomenon of perspiration appeared more frequently in the M group (44 vs. 29%, P<0.05). Two groups showed no significant differences in angiographic findings in terms of the number of involved branches, severity of coronary lesion and ratio of patients who underwent PCI. CONCLUSION Some differences exist in clinical characteristics between female and male patients with premature coronary heart disease. Both sexes showed no significant differences in angiographic findings.

参考文献/References

[1]中华心血管病杂志编委会血脂异常防治对策组.血脂异常防治建议[J].中华心血管病杂志,1997,35(5):390-419.
[2]张婷婷,田 然,张抒扬,等.早发急性冠状动脉综合征临床特点分析[J].中华心血管病杂志,2014,42(5);392-395.
[3]Canto AJ,Kiefe CI,Goldberg RJ,et al.Differences in symptom presentation and hospital mortality according to type of acute myocardial infarction[J].Am Heart J,2012,163(4):572-579.
[4]Shaw LJ,Bugiardini R,Merz CN.Women and ischemic heart disease:evolving knowledge[J].J Am Coll Cardiol,2009,54(17):1561-1575.
[5]Khan NA,Daskalopoulou SS,Karp I,et al.Sex differences in acute coronary syndrome symptom presentation in young patients[J].JAMA Intern Med,2013,173(20):1863-1871.
[6]Messner B1,Bernhard D.Smoking and cardiovascular disease: mechanisms of endothelial dysfunction and early atherogenesis[J].Arterioscler Thromb Vasc Biol,2014,34(3):509-515.
[7]Klatsky AL.Alcohol,cardiovascular diseases and diabetes mellitus[J].Pharmacol Res,2007,55(3):237-247.
[8]Estruch R,Ros E,Salas-Salvadó J,et al.Primary prevention of cardiovascular disease with a Mediterranean diet[J].N Engl J Med,2013,368(14):1279-1290.
[9]严 红，毕君富,张 斌,等.年龄≤50岁女性冠心病患者危险因素及冠状动脉造影特点[J].中国介入心脏病学杂志,2014,22(5);308-312.
[10]Adao L,Santos L,Bettencourt N,et al.Acute coronary syndromes in young women[J].Rev Port Cardiol,2004,23(1):69-77.
[11]Canto JG,Goldberg RJ,Hand MM,et al.Symptom presentation of women with acute coronary syndromes:myth vs reality[J].Arch Intern Med,2007,167(22):2405-2413.
[12]Akosah KO,Cemiglia RM,Havlik P,et al.Myocardial infarction in young adults with low -density lipoprotein cholesterol levels[13]Hochner-Celnikier D,Manor O,Gotzman O,et al.Gender gap in coronary artery disease：comparison of the extent，severity and risk factors in men and women aged 45-65 years[J].Cardiology,2002,97(1):18-23.

备注/Memo

备注/Memo:
收稿日期：2014-10-24.
作者简介：王学忠，副主任医师 Email:wxz27006@126.com
更新日期/Last Update: 2015-07-23