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[年轻女性急性心肌梗死的临床及冠状动脉造影特征]

[Clinical and coronary angiographic features of young women with acute myocardial infarction].

作者信息

Li Zhao, Li Zhi-zhong, Gao Yu-long, Tao Ying, Wang Su, Wang Qian, Ma Chang-sheng, DU Xin

机构信息

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2012 Mar;40(3):225-30.

Abstract

OBJECTIVE

To observe the clinical and coronary angiographic features of young women (≤ 44 years) with acute myocardial infarction (AMI).

METHODS

Clinic and coronary angiographic features were compared among 57 young women with AMI and 60 non-CHD young women, 78 young men with AMI and 80 elderly women with AMI were included, all patients were admitted to hospital from June 2003 to December 2010 and underwent coronary angiography. Body mass index (BMI), smoking history, familial history of early coronary artery disease, essential hypertension, type 2 diabetes mellitus, hyperlipidemia, serum uric acid (UA), menopause, lipids, total bilirubin (TBil), direct bilirubin (DBil), hemoglobin (Hb), red cell distribution width (RDW), fasting blood glucose (FBG) were measured.

RESULTS

(1) Prevalence of essential hypertension, hypertriglyceridemia and levels of fasting blood glucose, triglyceride, serum uric acid were significantly higher while high density lipoprotein cholesterol, and hemoglobin were significantly lower in young women with AMI group than in age-matched non-CHD control group (all P < 0.05). (2) Logistic regression analysis showed that essential hypertension (OR = 23.187), lower hemoglobin level (OR = 1.010) and uric acid (OR = 1.040) were independent risk factors for young women with AMI (all P < 0.05). (3) Coronary angiography revealed normal coronary finding in 6 cases, single-vessel disease in 35 cases (26 cases with left anterior descending artery disease) and two-vessel disease in 12 patients. The ratio of single vessel disease involved left anterior descending artery in young women was higher than that of young men and old women with AMI (all P < 0.05).

CONCLUSION

Essential hypertension, lower hemoglobin and uric acid are risk factors of young women with AMI. Single vessel coronary disease is the most common coronary angiographic feature of young women with AMI.

摘要

目的

观察急性心肌梗死(AMI)年轻女性(≤44岁)的临床及冠状动脉造影特征。

方法

比较57例AMI年轻女性与60例非冠心病年轻女性、78例AMI年轻男性及80例AMI老年女性的临床及冠状动脉造影特征,所有患者均于2003年6月至2010年12月入院并接受冠状动脉造影。测量体重指数(BMI)、吸烟史、早发冠状动脉疾病家族史、原发性高血压、2型糖尿病、高脂血症、血清尿酸(UA)、绝经情况、血脂、总胆红素(TBil)、直接胆红素(DBil)、血红蛋白(Hb)、红细胞分布宽度(RDW)、空腹血糖(FBG)。

结果

(1)AMI年轻女性组原发性高血压、高甘油三酯血症患病率及空腹血糖、甘油三酯、血清尿酸水平显著高于年龄匹配的非冠心病对照组,而高密度脂蛋白胆固醇和血红蛋白水平显著低于对照组(均P<0.05)。(2)Logistic回归分析显示,原发性高血压(OR=23.187)、较低的血红蛋白水平(OR=1.010)和尿酸(OR=1.040)是AMI年轻女性的独立危险因素(均P<0.05)。(3)冠状动脉造影显示6例冠状动脉正常,35例单支血管病变(其中26例为左前降支病变),12例双支血管病变。AMI年轻女性单支血管病变累及左前降支的比例高于AMI年轻男性和老年女性(均P<0.05)。

结论

原发性高血压、较低的血红蛋白和尿酸是AMI年轻女性的危险因素。单支冠状动脉病变是AMI年轻女性最常见的冠状动脉造影特征。

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