摘要
目的探讨女性冠心病经皮冠状动脉介入治疗(PCI)的临床特点及PCI治疗前服用β-受体阻滞剂对患者的保护作用。方法选择冠心病患者,男191例作为男性组,女75例作为女性组,均于PCI治疗前服用β-受体阻滞剂,同时收集拟行PCI的女性患者50例,术前及术后均未服用β-受体阻滞剂。所有患者均行PCI,并抽取肘静脉血测定肾上腺素(E)、去甲肾上腺素(NE)、肌酸磷酸激酶同工酶(CK-MB)及肌钙蛋白T(TNT)。结果与男性组比较,女性组的多支病变明显增高(P均<0.05),PCI术后出血事件、肾功能衰竭及死亡率等并发症均显著增加(P均<0.05)。与服用β-受体阻滞剂女性组比较,未服用药物的患者PCI术前和术后E(P<0.01)、NE(P<0.05)均明显增高,术后CK-MB和TNT均显著增高(P均<0.01);其心血管事件(MACE)、心绞痛、心律失常、出血事件的发生率和死亡率均显著升高。结论女性患者冠心病病情及PCI术后较男性严重,提前服用β-受体阻滞剂具有保护作用。
Objective To evaluate the clinical characteristics in female patients with coronary heart disease after percutaneous coronary intervention （ PCI） and the protective influence of β-adrenergic blocker therapy on patients before PCI. Methods We recruited 266 consecutive subjects with coronary heart disease （191 males,75 females） treated withβ-adrenergic blocker before and after PCI. 50 consecutive subjects with coronary heart disease were also involved, but they did not received β-adrenergic blocker therapy. Data were examined for gender-specific differences regarding patients＇ characteristics,angiographic findings,procedural details and adverse events at 1 year after PCI. Also,a blood sample was collected from each subject to determine the levels of creatine kinase-MB,TNT,E and NE. Results Compared with male subjects,multi-vessel lesions were significantly higher in female subjects. Also,women had significantly higher prevalence of cumulative vascular complications,renal failure and unadjusted mortality. E,NE,CK-MB and TNT levels significantly increased before and after PCI in the female coronary heart disease subjects withoutβ-adrenergic blocker therapy compared with those treated with β-adrenergic blocker. Overall,female subjects withoutβ-adrenergic blocker therapy were more likely to have in-hospital major adverse cardiac events（MACE）,recurrent angina,cardiac arrhythmias and vascular complications. Conclusion Women who undergo PCI therapy for coronary heart disease often have severer coronary artery lesions and higher post-PCI complication and mortality rates. Oral administration of β-adrenergic blocker has a protective effect on female patients before PCI.
出处
《山东大学学报（医学版）》
CAS
北大核心
2010年第4期98-101,105,共5页
Journal of Shandong University:Health Sciences
基金
山东省卫生厅青年基金立项课题[2001(厅青基)-6]
