摘要
目的:通过比较男性和女性急性心肌梗死(AMI)患者的临床特征及住院治疗,探讨不同性别住院死亡率差异的原因。方法:回顾性研究1994年1月至2004年12月在我院住院的1246例男性和537例女性AMI患者,对比不同性别患者的临床特征、住院治疗和预后的差异。结果:与男性相比,女性患者年龄大[(67.7±8.5)岁vs(60.4±11.6)岁,P<0.001],高血压和糖尿病患病率高(51.40%vs39.25%,28.31%vs 14.69%,P均<0.001),入院时血清总胆固醇>4.68 mmol/L和心功能≥killipⅢ级者多(73.37%vs 57.22%,11.92%vs 5.22%,P均<0.001)。男性和女性的心绞痛史(64.53%vs 66.85%,P=0.344)、陈旧性心肌梗死史(8.91%vs 9.87%,P=0.519)和冠心病家族史(22.98%vs 20.68%,P=0.348)阳性率无显著性差异。男性患者多有吸烟和饮酒史(69.74%vs 14.71%,78.49%vs 24.77%,P均<0.001)。女性患者急性期再灌注治疗率(22.16%vs 28.01%,P=0.010)和住院期间β受体阻滞剂的使用率显著低于男性(64.43%vs 70.14%,P=0.017)。女性患者住院死亡率高于男性(11.92%vs 6.90%,P<0.001)。结论:女性AMI患者住院死亡率显著高于男性,造成这一差异的原因在于不同性别患者的临床特征和住院治疗不同,女性患者年龄大,伴随危险因素多,急性期再灌注治疗率和β受体阻滞剂的使用率亦显著低于男性。
Objective： To investigate the cause of the difference on in-hospital mortality between male and female patients with acute myocardial infarction （AMI）. Methods： A retrospective study was carried out in 1,246 male and 537 female patients with AMI who were admitted to Qilu ttospiial of Shandong University from Janua- ry 1994 to December 2004. Variables including baseline characteristics, in-hospital management and outcomes were recorded and compared between different gender groups. Results： Females were genemUy older than males （67.7 ± 8.5 vs 60.4 ± 11.6 years, P 〈 0. 001 ） and had a higher prevalence of hypertension（51.40% vs 39.25%, P 〈 0.001）and diabetes mellitus（28.31% vs 14.69%, P 〈 0.001）.The Killip class greater than or equal to m （11.92% vs 5.22%, P 〈 0.001） and the total cholesterol （TC） 〉 4.68 mmol/L（73.37% vs 57.22%, P 〈 0.001） were more common in females. There was no significant difference on the history of previous angina pectoris, myocardial infarction and family coronary heart disease between males and females （64.53% vs 66.85%, P = 0. 344; 8.91% vs 9.87%, P = 0.519;22.98% vs 20.68%, P = 0.348, respectively）, however, the history of cigarette smoking（69.74 % vs 14.71%, P 〈 0. 001 ） and alcohol drinking（78.49% vs 24.77 %, P 〈 0.001 ） was more common in males. Reperfusion therapy within the first 24 hours after symptom onset and β - blockers were underused during hospitalization phase in females compared with males （22.16% vs 28.01%, P =0.010; 64.43% vs 70.14%, P = 0. 017, respectively）. An increased mortality was demonstrated in females during the hospitalization phase of AMI（11.92% vs 6.90%, P 〈 0.001）. Conclusions： The in-hospital mortality of females is higher than that of males following AMI. Females are older and have more risk factors than males, and reperfusion therapy and and β-blockers are tmderused, all of which are important causes of the difference on in-hospital mortality between male and female patients with AMI.
出处
《山东大学学报（医学版）》
CAS
北大核心
2006年第8期785-788,793,共5页
Journal of Shandong University:Health Sciences
基金
国家自然科学基金资助项目(60271015)
卫生部临床学科重点项目(20044681)
山东省科学技术发展重点项目(2002BB1CJA1)
关键词
急性心肌梗死
性别因素
死亡率
Acute myocardial infarction
Sex factors
Mortality
