45岁以下青年女性急性心肌梗死的临床和冠状动脉病变特点
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The Study of Clinical and Coronary Angiographic Profile and the Relation Between C-Reactive Protein of Acute Myocardial Infarction Women Below 45
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    摘要:

    目的回顾分析45岁以下女性急性心肌梗死的临床和冠状动脉病变特点及C-反应蛋白与女性急性心肌梗死之间的相关性,探讨急性心肌梗死危险因素及C-反应蛋白对青年女性急性心肌梗死诊断的预测价值。方法选取2000年1月-2010年6月住院行冠状动脉造影证实为急性心肌梗死的45岁以下女性患者31例的急性心肌梗死患者临床资料、冠状动脉病变特点,检测C-反应蛋白、血脂、纤维蛋白原、血尿酸水平,应用logistic回归分析危险因素与青年女性急性心肌梗死的关联性。结果青年女性急性心肌梗死较同龄男性,急性心肌梗死家族史、高血压、糖尿病、心源性休克、C-反应蛋白水平显著升高。冠状动脉造影显示多支血管病病变为主,左前降支冠状动脉相关的急性心肌梗死病变约32.3%。完全血运重建率及PCI术后TIMI3级血流所占比例也较少,与男性比较差异有显著性(P><0.05)。两组出院30天死亡率(Or=1.23,95%CI为0.81-1.89)差异无显著性,但青年女性院内死亡率(Or=1.15,95%CI为1.04-1.37)高,男性患者1年死亡率更高(Or=1.21,95%CI为1.07-1.47)。接受介入治疗年青女性急性心肌梗死院内死亡率(Or=0.96,95%CI为0.74-1.26)及出院30天死亡率(Or=1.07,95%CI为0.90-1.29)差异无显著性,但1年死亡率更高(Or=1.13,95%CI为1.01-1.29)。结论45岁以下女性急性心肌梗死患者合并高血压、糖尿病、急性心肌梗死家族史、心源性休克、多支血管病和C-反应蛋白的比例较高,但完全血运重建率低,PCI术后1年死亡率高。因而有必要对年青女性人群最佳的急性心肌梗死治疗策略作进一步的研究。

    Abstract:

    Aim To perform a meta-analysis of clinical and angiographic and CRP characteristics of women patients(age≤45) with acute myocardial infarction(AMI) that investigated the the correlation between female AMI,AMI risk factors and CRP of young women on the diagnosis of AMI predictive value. Methods 31 female patients were enrolled which comfirmed AMI by coronary angiography from January 2000 to June 2010.We collected their clinical data of AMI patients,coronary lesions,detection of CRP,lipids,fibrinogen,serum uric acid level and used logistic regression analysis to detect the relevance between risk factors and young women AMI. Results Compared with the same age male AMI patients,the women patient′s AMI family history,hypertension,diabetes,cardiogenic shock,CRP levels were significantly higher and their coronary angiography showed multivessel disease disease-based,LAD lesions associated with about 32.3% of AMI.The complete PCI revascularization rate and TIMI3 blood flow recovery of female patients were less than male which had the significant difference(P><0.05).Two group's 30-day hospital mortality(Or=1.23,95%CI:0.81-1.89) had no significant difference,but the young female patients hospital mortality(Or=1.15,95%CI:1.04-1.37) was higher and male patients with a higher one year mortality(Or=1.21,95%CI:1.07-1.47).The female patients who received the intervention hospital mortality(Or=0.96,95%CI:0.74-1.26)and the 30-day mortality(Or=1.07,95%CI:0.90-1.29) had no significant difference,but one year mortality rate was higher(Or=1.13,95%CI:1.01-1.29). Conclusion The women patients with AMI below 45 had higher proportion of hypertension,diabetes,AMI family history,cardiogenic shock,MVD,CRP,but the low rate of complete revascularization and higher one year mortality rate after PCI.Therefore it is necessary to do the best study of AMI treatment for female patients.

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赵昕,韩雅玲,张新娅,许凤芝,佟铭,伊宪华,王效增.45岁以下青年女性急性心肌梗死的临床和冠状动脉病变特点[J].中国动脉硬化杂志,2010,18(12):989~992.

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  • 收稿日期:2010-08-29
  • 最后修改日期:2010-12-01
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