国人变异型心绞痛的临床特征及性别差异

发布时间：2018-03-03 10:18

本文选题：冠状动脉疾病　切入点：心绞痛　出处：《中国循环杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的:初步探讨国人中变异型心绞痛的临床特征及其性别差异。方法:回顾性分析2003-01至2009-12期间入住我院的312例自发的变异型心绞痛患者(未行激发试验)的临床资料,并对男女性别之间的临床特征进行比较,揭示性别之间的异同点。结果:变异型心绞痛好发于男性占87.8%(274/312),常见的危险因素包括吸烟、高血压、高脂血症;17.6%(55/312)的患者有过敏史;心绞痛发作时18.9%(59/312)的患者合并心律失常;造影发现有54.8%(155/283)的患者存在冠状动脉固定狭窄,7.1%(22/312)的患者合并冠状动脉肌桥。硝酸酯类、钙拮抗剂及支架置入术可以有效控制心绞痛的发作。与男性相比,女性变异型心绞痛患者中吸烟者比例低(10.5%vs 78.8%,P0.01),冠心病家族史比例高(31.6%vs11.3%,P0.01),室性心动过速(13.2%vs 3.6%,P0.05)及心室颤动(7.9%vs 1.8%,P0.05)发生的比例高。结论:变异型心绞痛为冠状动脉痉挛导致的心肌缺血,合并心律失常的比例较高,处理不及时可导致心肌梗死甚至猝死等严重情况。变异型心绞痛患者应常规接受冠状动脉造影,对于狭窄严重者应行支架置入术。与男性相比,女性变异型心绞痛患者中吸烟者比例较低,冠心病家族史比例较高,更容易出现室性心动过速及心室颤动等恶性心律失常。
[Abstract]:Objective: To explore the clinical features and gender differences in Chinese variant angina pectoris. Methods: a retrospective analysis of 2009-12 2003-01 to stay in our hospital 312 cases of spontaneous in patients with variant angina (without provocation test). The clinical data and clinical characteristics were compared between the sexes, reveal the gender the similarities and differences between. Results: variant angina occurs in males accounted for 87.8% (274/312), the common risk factors including smoking, hypertension, hyperlipidemia; 17.6% (55/312) of the patients had a history of allergies; angina pectoris 18.9% (59/ 312) of the patients with arrhythmia were found (54.8%; 155/283) of patients with coronary artery stenosis (22/312), 7.1% patients with coronary myocardial bridge. Nitrates, calcium antagonists and stent implantation can effectively control the onset of angina pectoris. Compared with male, female patients with variant angina In the low proportion of smokers (10.5%vs 78.8%, P0.01), high proportion of family history of coronary heart disease (31.6%vs11.3%, P0.01), ventricular tachycardia (13.2%vs 3.6%, P0.05) and ventricular fibrillation (7.9%vs 1.8%, P0.05). Conclusion: the proportion of high variant angina pectoris of coronary artery spasm caused by myocardial ischemia, and a higher proportion of arrhythmia, timely treatment can lead to myocardial infarction and sudden cardiac death. Patients with variant angina should routinely receive coronary angiography should be performed stenting for severe stenosis. Compared with male, female patients with variant angina in smokers is relatively low, a higher proportion of family history of coronary heart disease, more prone to ventricular tachycardia and ventricular fibrillation.

【作者单位】：中国医学科学院北京协和医学院国家心血管病中心阜外医院血脂异常与心血管疾病诊治中心;
【分类号】：R541.4

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