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| 未绝经女性冠心病患者行经皮冠状动脉介入治疗的临床特点分析 |
| 侯小玲1,刘冰2,陈思1,李丽君1,付振虹1,侯兵3* |
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(1. 中国人民解放军总医院第六医学中心心血管病医学部, 北京 100853;
2. 中国人民解放军970医院心内科, 威海 264200;
3. 海军军医大学(第二军医大学)第一附属医院保健科, 上海 200433
*通信作者) |
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| 摘要: |
| 目的 探讨行经皮冠状动脉介入（PCI）治疗的未绝经女性冠心病患者的临床特点。方法 回顾性分析2014年1月至2018年12月于解放军总医院第一医学中心行首次PCI治疗的74例未绝经和109例绝经女性冠心病患者的临床资料。比较两组患者一般情况、冠状动脉病变特征及术后1年内主要不良心血管事件（MACE）的发生情况，并通过多因素logistic回归分析探究术后MACE发生的独立危险因素。结果 未绝经组患者的高血压病患病率、吸烟率、低密度脂蛋白胆固醇水平、甘油三酯水平及总胆固醇水平均低于绝经组［41.9%（31/74） vs 72.5%（79/109）、0 vs 13.8%（15/109）、（2.40±0.86）mmol/L vs （2.71±0.95）mmol/L、（1.40±0.74）mmol/L vs （1.69±0.97）mmol/L、（3.88±1.02）mmol/L vs （4.39±1.05）mmol/L，P均＜0.05］，而自身免疫病患病率、左心室射血分数均高于绝经组［14.9%（11/74） vs 1.8%（2/109）、（62.4±4.9）% vs （60.0±5.4）%，P均＜0.05］。未绝经组患者左前降支和左主干病变的发生率均高于绝经组［83.8%（62/74） vs 67.9%（74/109）、14.9%（11/74）vs 4.6%（5/109），P均＜0.05］。未绝经组PCI术后1年内MACE的发生率高于绝经组［12.2%（9/74） vs 3.7%（4/109），P＜0.05］。多因素logistic回归分析显示，未绝经是女性冠心病患者PCI术后1年内发生MACE的独立危险因素（OR＝3.635，95% CI 1.075～12.283，P＝0.038）。结论 未绝经女性冠心病患者左前降支和左主干受累较多见，且经PCI治疗后1年内MACE的发生率较高。 |
| 关键词: 冠心病 未绝经女性 主要不良心血管事件 经皮冠状动脉介入 |
| DOI：10.16781/j.CN31-2187/R.20220666 |
| 投稿时间：2022-08-15修订日期：2022-11-14 |
| 基金项目: |
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| Clinical manifestations of premenopausal women with coronary artery disease undergoing percutaneous coronary intervention |
| HOU Xiao-ling1,LIU Bing2,CHEN Si1,LI Li-jun1,FU Zhen-hong1,HOU Bing3* |
(1. Senior Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing 100853, China;
2. Department of Cardiology, No. 970 Hospital of PLA, Weihai 264200, Shandong, China;
3. Department of Health Care, The First Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the clinical manifestations of premenopausal women with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). Methods The clinical data of 74 premenopausal women and 109 postmenopausal women with CAD who underwent PCI in The First Medical Center of Chinese PLA General Hospital from Jan. 2014 to Dec. 2018 were retrospectively analyzed. The general data, coronary artery lesion characteristics and incidence of major adverse cardiovascular event (MACE) within 1 year after surgery were compared between the 2 groups. The independent risk factors of the postoperative MACE were investigated by multivariate logistic regression analysis. Results Compared with the postmenopausal group, the prevalence rates of hypertension and smoking and the levels of low density lipoprotein-cholesterol, triglyceride and total cholesterol were significantly lower in the premenopausal group (41.9% ［31/74］ vs 72.5% ［79/109］, 0 vs 13.8% ［15/109］, ［2.40±0.86］ mmol/L vs ［2.71±0.95］ mmol/L, ［1.40±0.74］ mmol/L vs ［1.69±0.97］ mmol/L, and ［3.88±1.02］ mmol/L vs ［4.39±1.05］ mmol/L, all P＜0.05), while the prevalence of autoimmune diseases and the left ventricular ejection fraction were significantly higher in the premenopausal group (14.9% ［11/74］ vs 1.8% ［2/109］ and ［62.4±4.9］% vs ［60.0±5.4］%, both P＜0.05). The incidence rates of left anterior descending artery and left main disease lesions were significantly higher in the premenopausal group than those in the postmenopausal group (83.8% ［62/74］ vs 67.9% ［74/109］ and 14.9% ［11/74］ vs 4.6% ［5/109］, both P＜0.05). The incidence of MACE within 1 year after PCI was significantly higher in the premenopausal group than that in the postmenopausal group (12.2% ［9/74］ vs 3.7% ［4/109］, P＜0.05). Multivariable logistic regression analysis showed that premenopause was an independent risk factor of MACE within 1 year after PCI in female CAD patients (odds ratio＝3.635, 95% confidence interval 1.075-12.283, P＝0.038). Conclusion Premenopausal females with CAD have higher incidence rates of left anterior descending and left main artery lesions and higher incidence of MACE within 1 year after PCI. |
| Key words: coronary artery disease premenopausal women major adverse cardiovascular events percutaneous coronary intervention |
