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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 investigate the clinical features of percutaneous coronary intervention (PCI) in female patients with coronary heart disease (CHD) and the protective effect of taking beta-blockers before PCI. Methods 191 patients with coronary heart disease were selected as male and 75 female as the female group. All of them were given β-blockers before PCI, and 50 female patients undergoing PCI were enrolled. Before and after operation Did not take β-blockers. All patients underwent PCI and the elbow venous blood samples were collected for the determination of epinephrine (E), norepinephrine (NE), creatine phosphokinase isoenzyme (CK-MB) and troponin T (TNT). Results Compared with the male group, the multi-vessel lesion in the female group was significantly increased (all P <0.05). The complications such as bleeding, renal failure and mortality were significantly increased after PCI (all P <0.05). Compared with the women taking β-blocker, the patients before and after taking PCI had significantly higher E (P <0.01), NE (P <0.05), and CK-MB and TNT after operation (P <0.01). The incidences of cardiovascular events (MACE), angina pectoris, arrhythmias, and bleeding events were significantly increased as well as the mortality rate. Conclusion The prevalence of coronary heart disease in female patients and the severity of male patients after PCI are higher than those before men taking beta-blockers.