【摘要】 目的探讨年龄在50岁以下的停经与未停经的女性冠状动脉粥样硬化性心脏病(冠心病)患者的危险因素、临床及冠状动脉造影特点。方法选取经临床及冠状动脉造影确诊的年龄50岁以下女性冠心病住院患者共173例,按月经情况分为停经组与未停经组,对比分析两组间冠心病危险因素、临床及冠状动脉造影特点。结果未停经组年龄小于停经组,差异有统计学意义[(44.5±5.6)岁vs.(48.4±2.1)岁,P<0.05];两组体质量比较,差异无统计学意义(P>0.05)。未停经组血脂异常及糖尿病患者比例明显多于停经组,差异有统计学意义(15.0%vs.0,P<0.05;62.1%vs.42.4,P<0.05);空腹血糖浓度高于停经组,差异有统计学意义[(6.27±2.30)mmol/L vs.(5.40±0.90)mmol/L,P<0.05]。未停经组高密度脂蛋白浓度低于停经组,差异有统计学意义[(1.21±0.31)mmol/L vs.(1.02±0.28)mmol/L,P<0.05],而两组其他血脂成分(血清总胆固醇、低密度脂蛋白、三酰甘油、载脂蛋白A及载脂蛋白B100浓度)比较,差异均无统计学意义(P>0.05)。两组尿蛋白阳性患者比例、血清尿酸及血清肌酐浓度比较,差异无统计学意义(P>0.05)。未停经组患者左前降支及其分支受累率明显高于停经组,差异有统计学意义(76.4%vs.51.5%,P<0.05);发生急性心肌梗死的患者比例也比停经组高,差异有统计学意义(26.4%vs.6.1%,P<0.05)。结论年龄50岁以下女性冠心病患者,未停经患者比停经患者年轻,有血脂异常及糖尿病等冠心病危险因素的患者比已停经患者多。未停经患者比已停经年轻女性冠心病患者高危,需要及时识别并积极诊治。更多还原

【Abstract】 Objectives To investigate the risk factors,clinical and angiographic features in women with coronary artery disease(CAD) aged under 50 before and after menopause. Methods One hundred and seventy-three women with CAD aged under 50 were included and classified as pre-menopause group and post-menopause group. Differences in CAD risk factors,clinical and angiographic features between the two groups were analyzed. Results Patients in pre-menopause group were significantly younger than those in post-menopause group [(44.5±5.6) years vs.(48.4±2.1) years,P<0.05 ],while with similar body weights(P >0.05). There were much more patients with diabetes and dyslipidemia in premenopause group than in post-menopause group(15.0% vs. 0,P<0.05; 62.1% vs. 42.4,P<0.05) and serum glucose in pre-menopause group was significantly higher than that in post-menopause group [(6.27±2.30) mmol / L vs.(5.40±0.90)mmol / L,P<0.05 ]. Serum concentration of high-density lipoprotein(HDL) was significantly lower in pre-menopause group than in post-menopause group [(1.21±0.31) mmol / L vs.(1.02±0.28) mmol / L,P<0.05 ],while no significant difference as for other blood lipid components(total cholesterol,low-density lipoprotein,triglycerides,apolipoprotein A and apolipoprotein B100) was found between the two groups(all P >0.05). Percentage of patients with positive urine protein value,urine and serum creatinine were similar between the two groups(P>0.05). There were much more patients with diseased left anterior descending artery and suffered from acute myocardial infarction in pre-menopause group than in post-menopause group(76.4% vs. 51.5%,P<0.05; 26.4% vs. 6.1%,P<0.05). Conclusions Of female patients with CAD aged under 50,those who remain pre-menopausal are younger and with more CAD risk factors such as diabetes and dyslipidemia. These high-risk patients need to be screened and treated aggressively in the early stage.更多还原