Arnold A Z, Moodie D S
Department of Cardiology, Cleveland Clinic Foundation, OH 44195.
Cleve Clin J Med. 1993 Sep-Oct;60(5):393-8. doi: 10.3949/ccjm.60.5.393.
Heart disease in the leading cause of death in women of all ages in the United States, but data on coronary disease in young women remains sparse.
To identify and follow up a cohort of young women referred for the evaluation of coronary disease.
Retrospective review of the medical records.
Thirty-two women younger than 31 years met the entry criteria. The average age was 28 +/- 2.4 years, 28% had insulin-dependent diabetes mellitus, 38% had hypertension, 6% had congenital heart disease, 38% had a family history of coronary artery disease, 72% were smokers, and 28% used oral contraceptives. Serum cholesterol levels were > 5.17 mmol/L (200 mg/dL) in 71%, and the mean cholesterol level was 6.70 +/- 2 mmol/L (259 +/- 78 mg/dL). Resting electrocardiographic results were abnormal in 28 women (88%), 22 of whom had evidence of transmural myocardial infarction. Follow-up averaged 9.8 +/- 6.4 years. Five patients died, all of whom had hypertension, and 4 of whom had diabetic nephropathy and required dialysis.
Risk factors for coronary disease in young women include hypertension, hypercholesterolemia, diabetes mellitus, familial coronary disease, and smoking. Long-term prognosis is excellent for those without advanced diabetes mellitus and renal failure.
在美国，心脏病是各年龄段女性的主要死因，但关于年轻女性冠心病的数据仍然稀少。
识别并随访一组因冠心病评估而转诊的年轻女性。
对病历进行回顾性分析。
32名年龄小于31岁的女性符合入选标准。平均年龄为28±2.4岁，28%患有胰岛素依赖型糖尿病，38%患有高血压，6%患有先天性心脏病，38%有冠心病家族史，72%为吸烟者，28%使用口服避孕药。71%的患者血清胆固醇水平>5.17 mmol/L（200 mg/dL），平均胆固醇水平为6.70±2 mmol/L（259±78 mg/dL）。28名女性（88%）静息心电图结果异常，其中22名有透壁心肌梗死的证据。随访平均9.8±6.4年。5例患者死亡，均患有高血压，其中4例有糖尿病肾病且需要透析。
年轻女性冠心病的危险因素包括高血压、高胆固醇血症、糖尿病、家族性冠心病和吸烟。对于没有晚期糖尿病和肾衰竭的患者，长期预后良好。
