| ObjectiveTo explore the characteristics of coronary heart disease in women before and after menopause,so as to provide some basis for early prevention and clinical intervention of coronary heart disease in women at this special stage.MethodsA retrospective study of 40-55 years old women with suspected coronary heart disease was conducted from May 2018 to September 2019 in the Department of Cardiology,the First Affiliated Hospital of Nanchang University,there were 76 patients with coronary heart disease confirmed by coronary angiography(CHD group)and 245 patients without coronary heart disease(non-CHD group).Grouping:1.According to the results of coronary angiography,the patients were divided into CHD group and non-CHD group.2.The CHD group was divided into premenopausal coronary heart disease group and postmenopausal coronary heart disease group according to whether the patient was postmenopausal or not.3.According to the number of vessels in patients with coronary artery disease,the coronary artery disease group was divided into single vessel disease group,double vessel disease group and multi-vessel disease group.4.According to the Gensini Score of coronary artery disease,the coronary heart disease group was divided into low risk group(1?Gensini<30),medium risk group(30? Gensini<60)and high risk group(60?Gensini).General clinical data of the patients were recorded,including age,body mass index,blood pressure,previous history(including hypertension,diabetes,family history of coronary heart disease),smoking history,marital status,menopausal status,etc.Clinical manifestations,fasting blood glucose,blood lipid,uric acid,homocysteine,lipoprotein,mean platelet volume,platelet distribution width,creatinine,urea nitrogen and other blood test indicators were analyzed.Results1?321 perimenopausal women suspected of coronary heart disease in the chiefcomplaints of simple chest to see a doctor accounted for 37%,chest pain accounted for 15%,chest tightness with chest pain accounted for 22%,dizziness and palpitation and other symptoms accounted for 26%;there was no significant difference in chief complaint between CHD group and non-CHD group(p>0.05).2?Compared with the non-CHD group,the CHD group had higher levels of hypertensionme?menopause?TG?uric acid?homocysteine and thyroid-stimulating hormone(TSH),with statistically significant differences(p<0.05);the CHD group had higher diabetes mellitus?family history of coronary heart disease?smoking?abnormal rate of electrocardiogram?positive rate of exercise treadmill test?blood glucose level?low density lipoprotein cholesterol(LDL-C)levels were higher,and the differences were statistically significant(p<0.01).3?Compared with the premenopausal coronary heart disease group,the post-menopausal coronary heart disease group had higher rates of hypertension,diabetes and dyslipidemia,and the difference was statistically significant(p<0.01);fasting blood glucose?TG?LDL-C?lipoprotein(a)?uric acid?TSH?Gensini score was high in the postmenopausal coronary heart disease group;the post-menopausal coronary artery disease group had a higher rate of vascular lesions with double vessels or more,with statistically significant differences(p<0.05).4?Compared with the single-vessel lesion group,the levels of TG,LDL-C,lipoprotein(a),uric acid,Hcy and TSH were higher in the double-vessel or multi-vessel lesion group,with statistically significant differences(p<0.05);there were statistically significant differences between the two or more vessel lesion groups in patients with diabetes mellitus,smoking rate,Gensini score,and HDL-C level(p<0.01).Compared with the multi-vessel lesion group,the difference in Gensini score and HDL-C level in the double-vessel lesion group was statistically significant(p<0.01),the differences in TG levels were statistically significant(p<0.05).5?Compared with the low-risk group,the levels of postpranural blood glucose?TG?LDL-C?lipoprotein(a)?uric acid?Hcy and TSH were higher in the medium-risk or high-risk group,with statistically significant differences(p<0.05).Conclusion1?Women suspected of coronary heart disease in perimenopausal period oftenhave chest tightness?chest pain?heart palpitations and other symptoms,clinicians should be on the alert for missed diagnosis of coronary heart disease in the first diagnosis of this population.2?Hypertension?diabetes?smoking? menopause?blood glucose?blood lipid(including TG?HDL?LDL)?lipoprotein(a)?uric acid and Hcy are risk factors for coronary heart disease in perimenopausal women.3?The levels of blood glucose?blood lipid(including TG?HDL?LDL)?lipoprotein(a)? uric acid and TSH in postmenopausal patients with coronary heart disease are increased,which is closely related to the severity of coronary artery disease.4?Premenopausal patients with coronary heart disease mainly had single vessel disease,while postmenopausal patients with coronary heart disease had a significant increase in the incidence of double or more vessels,the severity of coronary artery disease is more serious in Postmenopausal women. |
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