目的:观察绝经期前女性冠心病(CHD)患者冠状动脉病变特点及其危险因素.方法:入选绝经期前女性冠心病患者102例作为观察组,平均(48.2±7.5)岁,同时入选同年龄段CHD男性及非CHD女性患者各100例作为对照组,所有患者均行常规生化,心电图,超声心动图以及冠状动脉造影检查.结果:与CHD男性患者比较,绝经期前CHD女性有糖尿病史者比例明显升高(18.0％比27.5％),而吸烟者(31.0％比12.7％)、患ST段抬高心肌梗死比例(15.0％比2.9％)明显减小,左室射血分数(LVEF)明显降低[(59.7±9.8)％比(52.8±8.5)％],C型病变(32.0％比56.9％),Gensini积分≥40的病例(32.0 ％比44.1％)明显增多,P均＜0.05.与非CHD女性相比,高血压(32.0％比52.9％),糖尿病患病率(9.0％比27.5％)及C反应蛋白水平[(11.35±8.35) mg/L比(16.40±6.49) mg/L]明显升高,LVEF [(59.9±5.3)％比(52.8±8.5)％]显著降低,P均＜0.05.结论:绝经期前女性冠心病患者冠状动脉病变较重,临床风险较高.%Objective: To observe characteristics of coronary artery lesions and its risk factors in premenopausal female patients with coronary heart disease (CHD). Methods: A total of 102 premenopausal female CHD patients were enrolled as observation group and their mean age was (48. 2 ± 7. 5) years old. Another 100 male CHD patients and 100 female non - CHD patients with same age were regard as control groups. All patients underwent routine biochemical examinations, echocardiography and coronary angiography examinations. Results: Compared with male CHD patients, there were significant increase in ratio of diabetes mellitus (18.0% vs. 27.5%), C type lesions (32. 0% vs. 56. 9%) and ratio of cases with Gensini scores ≥40 (32. 0% vs. 44. 1%), and significant decrease in ratios of smokers (31.0% vs. 12.7%) and patients with ST segment elevation myocardial infarction (15.0% vs. 2. 9%), and left ventricular ejection fraction [LVEF, (59. 7 ± 9. 8)% vs. (52. 8 ± 8. 5)%] in premenopausal female CHD patients, P<0. 05 all. Compared with female non- CHD patients, there were significant increase in incidence rates of hypertension (32. 0% vs. 52. 9%) and diabetes mellitus (9. 0% vs. 27. 5%) and level of C- reactive protein [ (11. 35 ± 8. 35) mg/L vs. (16. 40 ± 6. 49) mg/L], and significant decrease in LVEF [ (59. 9 ± 5. 3) % vs. (52. 8 ±8. 5)%] in premenopausal female CHD patients, P<0. 05 all. Conclusion: Coronary artery lesions are more severe and clinical risk is higher in premenopausal female patients with coronary heart disease.
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