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目的:探讨绝经期前、后女性急性心肌梗死(acutem yocardial infarction,AMI)患者的危险因素、发病特点、预后。方法:2007年1月～2011年1月北华大学附属医院收治的女性AMI患者310例,依据是否绝经及绝经年限分组并对危险因素、临床表现、并发症和入院30天病死率进行比较。结果:绝经前女性AMI患者与绝经后患者相比,高脂血症的发生率更低(OR=8.151,P=0.005);典型胸痛症状的发生与年龄(OR=0.881,P=0.001)及绝经年限(OR=2.600,P=0.025)差异有统计学意义;绝经年限与严重心律失常和心力衰竭(>KillipⅡ级)差异无统计学意义(P>0.05)。合并糖尿病和心力衰竭(>KillipⅡ级)是预测绝经后女性心肌梗死患者死亡率的独立危险因素(OR=1.081,P=0.043;OR=12.339,P<0.001)。结论:绝经期前、后女性心肌梗死患者具有不同的临床特点,应结合其临床特点,采取不同的预防和诊疗措施。
Objective: To investigate the risk factors, onset characteristics and prognosis of patients with pre-and post-menopausal women with acute myocardial infarction (AMI). Methods: From January 2007 to January 2011, 310 female patients with AMI were enrolled in the Affiliated Hospital of Beihua University. According to their menopause and menopause duration, the risk factors, clinical manifestations, complications and 30-day mortality rate were compared. Results: The incidence of hyperlipidemia was lower in premenopausal women with AMI compared with those in postmenopausal women (OR = 8.151, P = 0.005). The incidence of typical chest pain was significantly related to age (OR = 0.881, P = 0.001) There was significant difference between menopause duration (OR = 2.600, P = 0.025), menopause duration and severe arrhythmia and heart failure (> Killip Ⅱ grade) (P> 0.05). The combination of diabetes mellitus and heart failure (> Killip class II) were independent predictors of mortality in postmenopausal women with myocardial infarction (OR = 1.081, P = 0.043; OR = 12.339, P <0.001). Conclusion: Before and after menopause women with myocardial infarction have different clinical features, should be combined with its clinical features, take different preventive and diagnostic measures.