【摘要】 目的探讨不同性别非冠状动脉阻塞性胸痛患者冠脉血流储备的特点及影响因素。方法入选2011年10月至2017年9月于北京大学第三医院心内科就诊的302例影像学检查证实冠脉狭窄<50%的胸痛患者,行经胸多普勒超声心动图测定冠状动脉左前降支的冠脉血流储备(CFR),比较男女性CFR特点。结果研究对象平均年龄(60.1±9.1)岁,男性117例(38.7%)。总体CFR为2.92±0.64,女性CFR低于男性[(2.86±0.62)vs.(3.02±0.67),P=0.039]。总体人群出现冠状动脉微循环障碍(CMD),即CFR<2.5者77例(25.5%),男女两组间CMD发生率无差异。多元线性回归分析显示年龄、高血压病史及吸烟是男性CFR的独立影响因素,年龄和BMI是女性CFR的独立影响因素(P<0.05)。结论非冠脉阻塞性胸痛患者女性CFR低于男性,但两者CMD发生率无差异;年龄、高血压病史及吸烟是男性CFR独立影响因素,年龄和BMI是女性CFR独立影响因素。更多还原

【Abstract】 Objective To study the characteristics and influencing factors of coronary flow reserve(CFR)in different gender with chest pain with non-obstructive coronary artery disease. Methods From October 2011 to September 2017,302 patients with chest pain whose coronary stenosis was less than 50% confirmed by CAG or CTA in the Department of Cardiology,Peking University Third Hospital were enrolled. CFR in left anterior descending coronary artery was measured by transthoracic Doppler echocardiography. Analyze the characteristics and influencing factors of CFR in different gender.Results The average age of the patients was(60.1+9.1)years,male 117(38.7%),and female 185(61.3%). The overall CFR was 2.92+0.64,and CFR was lower in female than in male[(2.86+0.62)vs.(3.02+0.67),P=0.039]. The overall incidence of CMD with CFR<2.5 was 25.5%,and there was no statistically significant difference in the incidence of CMD between male and female(P>0.05). Multivariate linear analysis showed that age,history of hypertension and smoking were independent influencing factors of the male CFR,while age and BMI were the independent influencing factors of the female CFR(P<0.05). Conclusion CFR in chest pain patients with non-obstructive coronary artery disease is lower in women than in men,but there is no difference in theincidence of CMD. Age,hypertension history andsmoking are independent factors of the male CFR,while age and BMI are independent factors of thefemale CFR.更多还原