Carey J S, Cukingnan R A, Singer L K
Department of Surgery, Torrance Memorial Medical Center, California.
Ann Thorac Surg. 1995 Jan;59(1):112-7. doi: 10.1016/0003-4975(94)00702-9.
We followed up 1,335 patients (287 female, 1,048 male) for 2 to 18 years (mean, 4.3 years) after they had undergone coronary artery bypass grafting. A health status index was calculated on the basis of their responses to annual questionnaires. The female patients were older (64.1 +/- 0.3 versus 60.4 +/- 0.3 years) and had a higher incidence of diabetes (28.6% versus 16.1%). The risk profile of women was otherwise similar to that of men. The hospital mortality was significantly higher in the women, particularly in those younger than age 60. The probability of survival (Kaplan-Meier) at 5, 10, and 15 years was lower in female patients at each interval. The mean health status index was also lower in women at 5, 10, and 15 years, and also lower in all subsets. In nondiabetic patients, the hospital mortality and probability of survival at 10 years did not differ between the female and male patients. In the diabetic patients, the hospital mortality was 11.0% (women) and 3.6% (men); the survival at 10 years was 0.42 (women) and 0.56 (men) (p < 0.001). Thus, the health status in women is less satisfactory than that of men after myocardial revascularization, and the probability of survival is lower. The excess mortality in female patients may be due to the higher incidence of diabetes in this group.
我们对1335例患者（287例女性，1048例男性）进行了随访，随访时间为冠状动脉搭桥术后2至18年（平均4.3年）。根据他们对年度问卷的回答计算健康状况指数。女性患者年龄较大（64.1±0.3岁对60.4±0.3岁），糖尿病发病率较高（28.6%对16.1%）。女性的风险特征在其他方面与男性相似。女性患者的医院死亡率显著更高，尤其是60岁以下的女性。在每个时间间隔，女性患者5年、10年和15年的生存概率较低。在5年、10年和15年时，女性的平均健康状况指数也较低，在所有亚组中也是如此。在非糖尿病患者中，女性和男性患者的医院死亡率和10年生存概率没有差异。在糖尿病患者中，医院死亡率为11.0%（女性）和3.6%（男性）；10年生存率为0.42（女性）和0.56（男性）（p<0.001）。因此，心肌血运重建后女性的健康状况不如男性，生存概率也较低。女性患者额外的死亡率可能归因于该组中较高的糖尿病发病率。
