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目的:对照分析行经皮冠状动脉介入治疗(PCI)的急性ST段抬高型心肌梗死(STEMI)女性和男性患者的临床特点及近远期临床疗效。方法:回顾分析2004-04至2008-12于我院行急诊PCI的STEMI女性患者118例(女性组),另选同期男性患者319例作为对照(男性组)。两组术后6个月后行临床冠状动脉造影随访,所有患者完成1年临床随访。结果:女性组的发病年龄和高血压、糖尿病比例均高于男性组(P均<0.05);吸烟比例低于男性组(P<0.05);三支病变、分叉病变比例女性组高于男性组(P<0.05),女性组靶病变血管直径、靶病变长度均少于男性组(P<0.05),两组患者其余的冠脉造影情况差异无统计学意义。两组术中心律失常、心源性休克发生率和主动脉内球囊反搏(IABP)应用比例等差异均无统计学意义(P>0.05)。女性组住院期心脏性死亡率显著高于男性组(P<0.05);两组急性心肌梗死再发生率、亚急性血栓发生率、院内靶病变血运重建及住院期主要不良心脏事件的差异均无统计学意义(P>0.05)。108例女性患者和307例男性患者完成1年临床随访,随访结果显示女性组心脏性死亡、急性心肌梗死和主要不良心脏事件发生率均高于男性,差异均有统计学意义(P<0.05);两组随访期晚期血栓、支架内再狭窄和靶病变血运重建发生率的差异均无统计学意义(P>0.05)。Logistic多元回归分析显示,年龄、高血压、IABP和心源性休克为住院期心脏性死亡的独立危险因素;年龄和女性为随访期心脏性死亡的独立危险因素。结论:与男性相比,女性STEMI患者年龄较高,合并危险因素比例多,女性组住院期和随访期心脏性死亡率高于男性,两者有统计学差别。
Objective: To compare and analyze the clinical features and short-term and long-term clinical characteristics of women and men with acute ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Methods: A retrospective analysis was performed on 118 women with STEMI who underwent PCI in our hospital from 2004-04 to 2008-12 (female group), and 319 male patients at the same period as the control group (male group). Clinical coronary angiography was followed up after 6 months in both groups, and all patients completed one year clinical follow-up. Results: The age of onset and the incidence of hypertension and diabetes in the female group were significantly higher than those in the male group (P <0.05). The smoking rate in the female group was lower than that in the male group (P <0.05) (P <0.05). The diameter of target lesion and the length of target lesion in female group were less than those in male group (P <0.05). There was no significant difference between the two groups in other coronary angiography. There were no significant differences between the two groups in the incidence of arrhythmia, the incidence of cardiogenic shock and the ratio of intra-aortic balloon pump (IABP) (P> 0.05). The cardiac death rate in hospitalized women was significantly higher than that in men (P <0.05). The incidences of recurrent acute myocardial infarction, subacute thrombosis, revascularization in hospital, and major adverse cardiac events No statistical significance (P> 0.05). One hundred and eighty female patients and 307 male patients completed a one-year clinical follow-up. The follow-up results showed that the incidence of cardiac death, acute myocardial infarction and major adverse cardiac events were higher in women than in men (P <0.05) There was no significant difference in the incidence of thrombosis, in-stent restenosis and target revascularization between the two groups at follow-up (P> 0.05). Logistic multivariate regression analysis showed that age, hypertension, IABP and cardiogenic shock were independent risk factors for in-hospital cardiac death; age and women were independent risk factors for cardiac death at follow-up. CONCLUSIONS: Compared with males, STEMI in women has a higher age and a greater proportion of risk factors. The cardiac mortality rate in hospitalized and follow-up women is higher than that in males. There is a statistically significant difference between the two groups.