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目的总结分析(中青年)50岁以下进行冠状动脉介入治疗的女性和男性冠心病患者的临床特点及近远期临床疗效。方法选择2001年11月—2007年12月择期接受冠状动脉介入治疗的50岁以下所有未绝经的186例女性患者作为女性组,选择同期所有行冠状动脉介入治疗的50岁以下男性患者215例作为对照(男性组)。两组均在术后半年行临床冠状动脉造影随访,所有患者均临床随访一年。结果共入选186例女性患者240处病变,215例男性患者332处病变,两组均完成随访。女性组的血脂异常、陈旧性心肌梗死及吸烟史比例均低于男性组。左主干病变比例女性组高于男性组(11.3%比3.0%,P﹤0.01)。左前降支比例女性组高于男性组(61.3%比47.0%P﹦0.001)。右冠状动脉病变比例女性组低于男性组(16.3%比34.0%,P﹤0.001)。C型病变比例女性组低于男性组(36.3%比48.8%,P﹦0.008)。分叉病变比例女性组高于男性组(32.5%比11.1%,P﹤0.001)。住院期及1年随访期间,女性组与男性组主要不良心血管事件、血栓发生率及再狭窄率差异无统计学意义。结论病变位于左主干、前降支和分叉病变的比例50岁以下女性冠心病患者高于50岁以下男性冠心病患者,但是男性患者的冠心病危险因素较多、冠状动脉病变较严重。50岁以下男、女冠心病患者冠状动脉介入治疗的近远期疗效无显著性差异。
Objective To summarize the clinical features and short-term and long-term clinical effects of coronary artery disease in women and men under 50 years of age undergoing coronary intervention. Methods A total of 186 female patients under 50 years of age who underwent coronary artery intervention from November 2001 to December 2007 were enrolled in this study. All women under 50 years of age undergoing coronary intervention were enrolled as the female group. 215 Control (male group). All patients were followed up for clinical coronary angiography six months after operation. All patients were followed up for one year. Results There were 240 lesions in 186 female patients and 332 lesions in 215 male patients. All patients were followed up. The female group’s dyslipidemia, old myocardial infarction and smoking history were lower than the male group. The proportion of left main lesion was higher in women than in men (11.3% vs. 3.0%, P <0.01). The ratio of left anterior descending branch was higher in women than in men (61.3% vs 47.0%, P = 0.001). The proportion of right coronary lesions was lower in women than in men (16.3% vs 34.0%, P <0.001). The proportion of type C lesion was lower in women than in men (36.3% vs 48.8%, P = 0.008). Bifurcation lesion proportions in females were higher than in females (32.5% vs 11.1%, P <0.001). During hospitalization and 1-year follow-up, there were no significant differences in major adverse cardiovascular events, thrombosis and restenosis rates between female and male subjects. Conclusions The lesions are located in the left main trunk. The proportion of anterior descending coronary artery and bifurcation lesion in women under 50 years of age is higher than that of men under 50 years of age. However, there are more risk factors for coronary heart disease and more serious coronary lesions in males. There was no significant difference in short-term and long-term effects of coronary intervention between men and women under 50 years of age in coronary heart disease.