目的:分析绝经前女性冠心病(CAD)患者的临床和冠状动脉(冠脉)造影特点。方法:对比2004-04至2007-12所有第一次因胸部不适而行冠脉造影的绝经前565例患者,根据造影结果分为绝经前冠心病组280例,平均年龄(44.12±4.48)岁,绝经前正常组285例,平均年龄(44.24±3.48)岁,绝经后经冠脉造影确定冠心病的患者为绝经后冠心病组721例,平均年龄(58.09±1.44)岁,分析其临床和冠脉造影特点。结果:绝经前冠心病组与绝经后冠心病组相比,高血压(55%比66%)、2型糖尿病(15.0%比31.5%)和高脂血症(23.9%比37.4%)的发生率显著减少,P均<0.05。绝经前冠心病组比绝经后冠心病组单支病变的发生率显著增高(43.2%比26.9%,P<0.001),差异有统计学意义;而三支病变的发生率则显著降低(20.4%比33.8%,P<0.001);左主干(2.9%比1.1%,P=0.048)和前降支近端(50.4%比38.6%,P<0.001)重度狭窄(狭窄≥90%)的发生率却显著增高,差异有统计学意义。结论:绝经前女性具有典型胸痛症状,冠脉造影常显示严重的冠脉狭窄病变,而且这些病变常位于左主干和前降支近端。 OBJECTIVE: To analyze the clinical and coronary (coronary) angiographic characteristics of premenopausal women with coronary heart disease (CAD). Methods: A total of 565 premenopausal women undergoing coronary angiography for chest discomfort for the first time from 2004-04 to 2007-12 were divided into 280 cases of premenopausal coronary heart disease group (mean age: 44.12 ± 4.48) years , 285 cases of premenopausal normal group, mean age (44.24 ± 3.48) years old, postmenopausal coronary angiography to determine coronary heart disease patients were 721 cases of postmenopausal coronary heart disease group, mean age (58.09 ± 1.44) years old, analysis of its clinical and Coronary angiography features. Results: Hypertension (55% vs 66%), type 2 diabetes (15.0% vs 31.5%), and hyperlipidemia (23.9% vs 37.4%) occurred in premenopausal women with coronary heart disease compared with menopausal women with coronary heart disease The rates were significantly reduced, P <0.05. The incidence of single vessel disease in premenopausal patients with coronary heart disease was significantly higher than that in patients with postmenopausal coronary heart disease (43.2% versus 26.9%, P <0.001), but the incidence of three lesions was significantly lower (20.4% (P <0.001). The incidence of severe stenosis (stenosis≥90%) in the left main (2.9% vs 1.1%, P = 0.048) and proximal anterior descending (50.4% vs 38.6%, P <0.001) But significantly higher, the difference was statistically significant. CONCLUSION: Premenopausal women have typical symptoms of chest pain. Coronary angiography often shows severe coronary artery stenosis, and these lesions are often located proximal to the left main and anterior descending branches.