急性心肌梗塞过程的性别特征

Т. М. Мураталиев, В. К. Звенцова, Ю. Н. Неклюдова, З. Т. Раджапова, С. Ю. Мухтаренко
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引用次数: 16

摘要

目的:探讨性别特征及其在急性心肌梗死(MI)进展和治疗中的作用。材料和方法。244例30 ~ 85岁(平均年龄61.2±12.3岁)MI患者纳入本研究。根据他们的性别,他们被分为两组:第一组由80名(32.8%)女性组成,第二组由164名(67.2%)男性组成。我们评估了患者的人口统计数据、诊断及其并发症、合并症、冠心病(CHD)的病史和危险因素(RF)、住院治疗活动、住院死亡率和心肌梗死后12个月死亡率。在女性中,心肌梗死更常与动脉高血压相关(p 0.05),但严重(III-IV级)心力衰竭在女性人群中更为常见(31.2% vs 23.7%;RR 1.31;95% ci 0.85-2.01;P < 0.05)。女性死亡率高于男性(27.5% vs 15.2%;RR 1.8;95% ci 1.08-2.99;р0.05)。在心肌梗死后的前6个月,我们发现女性死亡率高于男性(6.2% vs 1.8%;RR 3.41;95% ci 0.83-13.9;P < 0.05),但在出院后6-12个月,男性的死亡率往往高于女性(4.3% vs 2.5%;RR 0.58;95% ci 0.12-2.75;P < 0.05)。结论。女性心肌梗死最重要的危险因素是糖尿病、动脉高血压和肥胖。女性心肌梗死与严重心衰发展相关;她们的直接预后和疾病结果通常不如男性。
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ГЕНДЕРНЫЕ ОСОБЕННОСТИ ТЕЧЕНИЯ ОСТРОГО ИНФАРКТА МИОКАРДА
Objective: investigation of gender features and their role in progression and treatment of acute myocardial infarction (MI). Materials and methods. 244 patients aged 30–85 (mean age 61.2 ± 12.3) with MI were included in this study. They were divided into 2 groups depending on their gender: the 1st group was comprised of 80 (32.8 %) women, the 2nd group – of 164 (67.2 %) men. We evaluated patients’ demographic data, diagnosis and its complications, comorbidities, medical history and risk factors (RF) of coronary heart disease (CHD), in-patient therapeutic activities, in-hospital mortality rate, and 12-month mortality rate after MI. Results. In women MI was significantly more often associated with arterial hypertension (p 0,05), however severe (class III–IV) heart failure was more common in female population (31.2 % vs 23.7 %; RR 1.31; 95 % CI 0.85–2.01; p > 0.05).Mortality rate was higher in women than in men (27.5 % vs 15.2 %; RR 1.8; 95 % CI 1.08–2.99; р 0.05). During the first 6 months after MI we found a tendency of higher mortality rate in females than in males (6.2 % vs 1.8 %; RR 3.41; 95 % CI 0.83–13.9; p > 0.05), but after 6–12 months after discharge males tended to have higher mortality than females (4.3 % vs 2.5 %; RR 0.58; 95 % CI 0.12–2.75; p > 0.05). Conclusion. The most important risk factors for MI in females are diabetes mellitus, arterial hypertension and obesity. MI in women is associated with severe HF development; their immediate prognosis and disease outcome is usually less favorable, than in men.
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