摘要
目的:通过回顾性分析青年女性急性心肌梗死(acute myocardial infarction,AMI)的临床和冠状动脉病变特点,探讨青年女性AMI发病危险因素及与冠状动脉病变严重程度的关系.方法:本研究选取了 2018年10月至2023年4月间,首都医科大学附属北京天坛医院收治的52例青年女性和592例青年男性AMI患者及90例同期住院青年健康女性对照者.我们收集、整理并分析了这些患者的临床数据、AMI危险因素以及冠状动脉病变的特点和严重程度,并运用Logistic回归分析方法,探索了危险因素与青年女性AMI患者冠状动脉病变严重程度的相关性.结果:与同龄男性AMI患者相比,青年女性AMI患者中AMI家族史、高血压和糖尿病的发病率显著更高.冠状动脉造影显示,这些女性患者的多支血管冠状动脉病变(multivessel coronary artery disease,MVD)发病率达到了 40.4％,其中右冠状动脉病变占42.3％,均明显高于青年男性组.此外,冠状动脉介入术后T1MI3级血流比例在女性组中也明显低于男性组.随着冠状动脉病变血管支数的增加,危险因素(如高血压病、2型糖尿病、高脂血症、高尿酸血症、纤维蛋白原水平、吸烟量)的发生率也相应增加.多因素Logistic回归分析显示,糖尿病、血尿酸水平、吸烟量和AMI家族史是青年女性AMI患者冠状动脉病变严重程度的危险因素.结论:青年女性AMI患者的冠状动脉病变程度随着危险因素的增多而加重,尤其与糖尿病、血尿酸水平、吸烟和AMI家族史有着显著的正相关关系,积极有效地控制AMI的危险因素对于预防青年女性AMI的发生具有重要意义.
Abstract
Objective:We retrospectively analyzed the clinical characteristics and coronary artery lesions of acute myocardial infarction(AMI)in young women,to investigate the risk factors of AMI and the relationship with the severity of coronary artery lesions in young women.Methods:From October 2018 to April 2023,we enrolled 52 young female patients and 592 young male patients who were admitted to our hospital and confirmed by coronary angiography with AMI,and 90 hospitalized healthy young women were included as the control group.We collected,sorted,and analyzed their clinical data,AMI risk factors,and the characteristics and severity of their coronary artery lesions.Logistic regression was used to analyze the association of risk factors with the severity of coronary artery lesions in young female patients with AMI.Results:Young female patients with AMI showed a significantly higher prevalence of family history of AMI,hypertension,and diabetes compared to their male counterparts.Coronary angiography indicated that the rate of multivessel coronary artery disease(MVD)in these females was 40.4％and the rate of right coronary artery lesions was 42.3％,both significantly higher than young males.Additionally,after coronary intervention,the proportion of T1MI3-level blood flow was significantly lower in females than in males.With the number of affected coronary arteries increased,the incidence of risk factors such as hypertension,type 2 diabetes,hyperlipidemia,hyperuricemia,fibrinogen levels and smoking quantity also increased.Multivariate logistic regression analysis revealed that diabetes,blood uric acid levels,smoking quantity and family history of AMI were independent risk factors for the severity of coronary artery lesions in young female patients with AMI.Conclusions:The severity of coronary artery lesions in young female AMI patients increases with the increase in risk factors,and there is a significant positive correlation with diabetes,blood uric acid levels,smoking and family history of AMI.Active and effective control of the risk factors of AMI play a vital role in preventing the occurrence of AMI in young women.
维普
万方数据