摘要
目的确定经皮冠状动脉介入治疗的住院及远期死亡率是否存在性别差异以及该差异是否与年龄有关。方法回顾性分析2004年7月1日至2005年9月30日行单纯PCI治疗的2493例患者,并进行随访,记录临床情况及随访数据。按照性别及年龄分组(<65岁和≥65岁)比较它们之间基本临床特征、住院死亡率及远期死亡率的差异。结果女性年龄较大,术前合并主要疾病的比例较男性高,既往心肌梗死病史及血运重建史较男性少,住院死亡率女性高(1.1%:0.1%),且主要表现在低龄组(0.7%:0%);中位数随访时间555天,随访率93.4%,女性远期死亡率高于男性(HR 3.012,95%CI 1.094～8.293);按照年龄分组显示,远期死亡率的性别差异仅表现在低龄组(HR 4.203,95% CI1.355～13.032),而高龄组则无差异(HR1.700,95% CI0.496～5.787)。结论接受经皮冠状动脉介入治疗的女性术后住院及远期死亡率均高于男性,但仅表现在<65岁的低龄女性。低龄女性是远期死亡率的独立危险因素。
Objective The purpose of this study was to investigate gender differences on in-hospital mortality and long-term mortality after percutaneous coronary intervention （PC/） and explore whether the gender differences de- pend on age further. Methods A total of 2493 patients including 1860 men （male group） and 633 women（ female group） who underwent PCI between July 1 st,2004 and September 30st,2005 in Beijing Anzhen Hospital were retro- spectively investigated and followed up, the risk factors before PCI and in-hospital mortality and long-term mortality rates were compared according to different age and gender group. Results Women undergoing PCI were older, and had more comorbidity than men. Men were more likely to have prior myocardial infarction, and prior coronary revas- cularization. In-hospital mortality post PCI were low; however, women demonstrated a higher mortality compared with men （ 1.1% vs. 0.1% ,P 〈0.001 ） ,and the difference is only apparent in younger group（0.7% vs. 0% ,P = 0.036）. 93.4% of the patients were successfully followed up with a median of 555 days. After adjusting for baseline clinical risk factors, women had higher long-term mortality risk （ adjusted hazard ratio 3. 012, 95% confidence in- terval 1. 094 to 8. 293, P = O. 033）. However, only women in younger group had higher long-term mortality（ adjus- ted hazard ratio 4.203, 95% confidence interval 1. 355 to 13. 032, P =0.013） while older women not. Condu- sions Women had a higher in-hospital and long-term mortality rate post PCI than men. Further, the difference of gender only reside in younger group. Younger women was an independent risk factor for long-term mortality.
出处
《中国医刊》
CAS
2010年第3期43-46,共4页
Chinese Journal of Medicine
基金
国家重点基础研究发展规划基金资助项目(基金编号2003CB517103)
首都医科大学基础-临床联合课题基金资助(基金编号2007jl45)
关键词
冠状动脉疾病
血管成形术
经腔
经皮冠状动脉
性别
死亡率
Coronary artery disease ： Angioplasty
transluminal, percutaneous coronary
Gender
Mortality
