绝经前后女性非ST段抬高型心肌梗死患者院内死亡率的特点研究

摘要

Objective To analyze the in-hospital mortality of non-ST-segment elevation myocardial infarction (NSTEMI) in premenopausal and postmenopausal female patients.Methods Two hundred and ninety-five female patients with NSTEMI from January 1994 to December 2006,including 48 premenopausal patients (premenopausal group) and 247 postmenopausal patients (postmenopausal group) were retrospectively analyzed.The baseline data and in-hospital mortality were compared between groups and the influence of menopause on inhospital mortality was analyzed.Results The age,the patient proportions of dyslipidemia and complications,the in-hospital mortality were significantly higher,the proportion of mental labors was significantly lower in postmenopausal group than those in postmenopausal group [(72 ± 5) years vs (52 ± 6) years,50.6％ (125/247) vs 27.1％ (13/48),45.7％ (113/247) vs 22.9％ (11/48),20.6％ (51/247) vs 4.2％ (2/48),2.4％ (6/247) vs 8.3％ (4/48)] (P ＜ 0.05).In univariate Logistic regression,the menopause played an important role on in-hospital mortality (odds ratio:5.985,95％ confidence interval:1.405-25.484,P =0.016);after adjustment of confounding factores,the age and dyslipidemia were independent risk factors for in-hospital mortality in female patients with NSTEMI (odds ratio:1.054,P =0.024;odds ratio:3.096,P =0.001),while the menopause was not (P =0.255).Conclusion The in-hospital mortality of NSTEMI in postmenopausal patients is significantly higher than that in premenopausal patients,the age and dyslipidemia are independent predictors of in-hospital mortality.%目的 研究绝经前后女性非ST段抬高型心肌梗死(NSTEMI)患者院内死亡率的特点.方法 回顾性选取1994年1月至2006年12月首都医科大学宣武医院收治的女性NSTEMI患者295例,其中绝经前(绝经前组)48例,绝经后(绝经后组)247例.比较2组患者基线资料和院内死亡率,分析绝经对女性NSTEMI患者院内死亡率的影响.结果 绝经后组平均年龄大于绝经前组[(72±5)岁比(52±6)岁]、血脂异常者比例高于绝经前组[50.6％ (125/247)比27.1％(13/48)]、脑力劳动者少于绝经前组[2.4％(6/247)比8.3％ (4/48)]、出现并发症者多于绝经前组[45.7％ (113/247)比22.9％ (11/48)]、院内死亡率高于绝经前组[20.6％(51/247)比4.2％ (2/48)],差异均有统计学意义(均P＜0.05).消除混杂因素前,绝经对女性NSTEMI患者院内死亡率的影响明显(比值比=5.985,95％置信区间:1.405～25.484,P =0.016);校正血脂异常、年龄、脑力劳动者比例等混杂因素后发现,血脂异常(比值比=3.096,P=0.001)和年龄(比值比=1.054,P=0.024)是女性NSTEMI患者院内死亡率的独立危险因素,而绝经本身并不影响患者的院内死亡率(P =0.255).结论 绝经后女性NSTEMI患者院内死亡率明显高于绝经前女性,与绝经后患者年龄大、血脂异常有关.