Waters D D, Halphen C, Theroux P, David P R, Mizgala H F
Am J Cardiol. 1978 Jul;42(1):41-7. doi: 10.1016/0002-9149(78)90982-7.
Coronary arteriography was performed because of suspected coronary disease in 239 women less than 45 years of age. Normal coronary arteries were found in 112 women, and a further 23 had insignificant stenosis (less than 50 percent narrowing of luminal diameter). Of the remaining 104 women, 56 had one vessel, 22 two vessel and 26 three vessel disease. Hyperlipidemia, hypertension, diabetes, smoking and a family history of coronary disease were significantly more frequent in women with significant stenosis than in women with normal arteries. Significant coronary disease was found in 55 percent (100 of 182) of women with more than two risk factors but in only 7 percent (4 of 57) of those with less than two risk factors (P less than 0.0001). Evaluation of symptoms and the resting electrocardiogram also discriminated between women with and without coronary disease, but exercise testing was of little value. Only 4 of the 46 women with previous myocardial infarction had normal or near-normal coronary arteries. Among women with segmental wall motion abnormalities on ventriculography, the site was anterior in 90 percent (19 of 21) of women who used oral contraceptive drugs but in only 60 percent (21 of 35) of nonusers (P less than 0.05). However, in most respects, coronary artery disease in young women does not appear to differ from coronary disease in other patients.
对239名年龄小于45岁、疑似患有冠状动脉疾病的女性进行了冠状动脉造影。在112名女性中发现冠状动脉正常，另有23名女性存在轻度狭窄（管腔直径狭窄小于50%）。在其余104名女性中，56名有单支血管病变，22名有双支血管病变，26名有三支血管病变。与冠状动脉正常的女性相比，有明显狭窄的女性中高脂血症、高血压、糖尿病、吸烟以及冠心病家族史更为常见。在有两种以上危险因素的女性中，55%（182名中的100名）发现有明显的冠状动脉疾病，而在危险因素少于两种的女性中，只有7%（57名中的4名）有明显的冠状动脉疾病（P<0.0001）。对症状和静息心电图的评估也能区分有无冠状动脉疾病的女性，但运动试验价值不大。在46名曾患心肌梗死的女性中，只有4名冠状动脉正常或接近正常。在心室造影显示节段性室壁运动异常的女性中，90%（21名中的19名）口服避孕药的女性病变部位在前壁，而未服用避孕药的女性中只有60%（35名中的21名）病变部位在前壁（P<0.05）。然而，在大多数方面，年轻女性的冠状动脉疾病似乎与其他患者的冠状动脉疾病并无不同。
