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目的:分析育龄及绝经后妇女胸痛患者冠状动脉特点及绝经的关系。方法:230例因胸痛、胸闷就诊临床疑诊为冠心病的育龄及绝经后妇女入院行冠状动脉造影,对冠状动脉造影结果与临床资料进行回顾性分析。结果:(1)育龄妇女疑为冠心病的胸痛患者,冠状动脉造影阳性率(35.0%)较低,而绝经后妇女冠状动脉造影阳性率明显增加(79.3%,P<0.01)。(2)育龄妇女疑诊冠心病患者如合并高血压、糖尿病、高脂血症、家族史对冠心病的诊断预测价值有一定意义。(3)无创检查中常规心电图阳性97例(准确性52.6%),活动平板心电图阳性49例(准确性59.7%),超声心动图异常57例(准确性54.1%),诊断育龄妇女冠心病的诊断价值存在明显局限性。结论:育龄妇女冠心病发病率较低,若患病以单支病变为主,左前支架是最易累及血管,复杂病变少见。存在高血压、糖尿病、高脂血症、冠心病家族史的育龄妇女胸痛患者无论无创检查是否发现异常,均应尽早行冠状动脉造影以明确诊断。
Objective: To analyze the relationship between coronary artery characteristics and menopause in childbearing and post-menopausal women with chest pain. Methods: 230 cases of childbearing age and postmenopausal women admitted to hospital due to chest pain and chest tightness were retrospectively analyzed. Results of coronary angiography and clinical data were retrospectively analyzed. Results: (1) The prevalence of coronary angiography (35.0%) was lower in women of childbearing age who were suspected to have coronary heart disease. The positive rate of coronary angiography in postmenopausal women was significantly increased (79.3%, P <0.01). (2) The diagnosis of coronary heart disease in women of childbearing age patients with coronary heart disease such as hypertension, diabetes, hyperlipidemia, family history of coronary heart disease diagnosis has a certain value. (3) There were 97 cases (52.6%) of routine electrocardiogram positive in noninvasive examination, 49 cases of active electrocardiogram positive (accuracy 59.7%), 57 cases of abnormal echocardiography (accuracy 54.1%), diagnosis of coronary heart disease in women of childbearing age There are obvious diagnostic value limitations. Conclusion: The prevalence of coronary heart disease in women of childbearing age is low. If the disease is predominantly single, the left anterior stent is the most easily involved vascular, and the complicated lesions are rare. Patients with chest pain who have hypertension, diabetes, hyperlipidemia, and a family history of coronary heart disease should have coronary angiography as early as possible to confirm the diagnosis, regardless of whether they are found to be abnormal or not.