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目的探讨女性非ST段抬高急性冠脉综合症患者的临床特点和冠状动脉病变特点,为临床积极治疗提供参考。方法选择310例在我院经临床资料、冠状动脉造影确诊的女性NSTEACS患者为研究组,同期在我院经冠状动脉造影确诊的男性NSTEACS患者370例为对照组。分别对其临床特点和冠状动脉病变的支数、部位、狭窄类型及程度进行比较。结果⑴与男性相比,女性NSTEACS患者临床表现类型以急性心肌梗死更多见,典型的心绞痛症状和心电图缺血性表现较少,住院期间心功能不全发生率高于男性,吸烟史少、糖尿病史多,血脂异常以TG升高和HDL-C降低更为突出。低血红蛋白血症、高尿酸血症、高同型半胱氨酸血症和社会心理因素对女性的影响也较男性更为明显。而家族史、高血压病史与男性相比无明显差别。⑵与男性相比,女性NSTEACS患者冠状动脉单支病变明显低,而以多支病变明显,侧枝循环形成高于男性;受累血管以前降支最为常见,但两组相比无显著性差异,其次为右冠状动脉,与男性相比有显著性差异;病变血管的狭窄类型女性组以B、C型病变为多,但无统计学差异;病变血管的狭窄程度以gensini积分计算,女性组以中度升高比率为主,且明显高于男性。结论女性非ST段抬高急性冠脉综合症的临床表现类型以急性心肌梗死更多见,临床症状不如男性典型,TG升高和HDL-C降低更为突出,高尿酸血症、高同型半胱氨酸血症等新的危险因素在其发病中发挥了更重要的作用。女性冠脉病变以多支病变为多,侧枝循环形成高于男性。狭窄程度较男性重。
Objective To investigate the clinical features and characteristics of coronary lesions in women with non-ST-elevation acute coronary syndrome (ACS) and provide a reference for clinical active treatment. Methods A total of 310 female NSTEACS patients confirmed by coronary angiography in our hospital were selected as the study group and 370 male NSTEACS patients confirmed by coronary angiography in our hospital as control group. The clinical features and the number of coronary lesions, location, type and extent of stenosis were compared. Results (1) Compared with males, the clinical manifestations of NSTEACS in women were more common in acute myocardial infarction. The typical symptoms of angina and ECG were less ischemic, the incidence of heart failure during hospitalization was higher than that of males, smoking history was low, diabetes Stories, dyslipidemia to elevated TG and HDL-C decreased more prominent. Hypochromic hyperlipidemia, hyperuricemia, hyperhomocysteinemia and psychosocial factors affect women more than men. The family history, history of hypertension compared with men no significant difference. (2) Compared with males, the incidence of single coronary artery disease in women with NSTEACS was significantly lower than that in males. However, with multi-vessel pathology, collateral circulation was significantly higher than that in males. The anterior descending artery involvement was the most common, but there was no significant difference between the two groups For the right coronary artery, compared with men, there was a significant difference; lesion vascular stenosis type of women group B, C-type lesions are more, but no significant difference; lesion vascular stenosis calculated by gensini points, the female group in the Degree increased mainly, and significantly higher than men. Conclusions The clinical manifestations of acute non-ST-segment acute coronary syndrome in women are more common in acute myocardial infarction. The clinical symptoms are not as good as those in men. The elevated TG and HDL-C are more prominent. Hyperuricemia and hyperhomocysteinemia New risk factors such as cystinemia play a more important role in their pathogenesis. Multiple coronary lesions in women with multiple lesions, collateral circulation formation higher than men. Stenosis heavier than men.