【摘 要】 目的 探讨女性早发冠心病(CHD)患者的心血管危险因素和冠状动脉病变特点。方法 纳入753例经冠状动脉造影确诊为早发CHD(男性<55岁，女性<65岁)患者，对男性组(507例)和女性组(246例)的3个常见心血管危险因素(糖尿病、血脂异常及高血压)和冠状动脉病变特点进行对比分析。结果 早发CHD男性组和女性组平均年龄相近，女性糖尿病患者比例显著高于男性组(33.74% vs 19.13%，P<0.001)，而高血压、血脂异常无差异；两组危险因素差异无统计学意义。心肌梗死多见于女性(67.47% vs 52.66%，P<0.05)。早发CHD单支病变占49.14%，部位以前降支为主(70.65%)，但两组冠状动脉造影结果比较，无论是狭窄程度、狭窄支数还是累及分支血管比例均无明显差异(P均>0.05)。结论 女性早发CHD冠状动脉病变并不轻于男性，对女性早发CHD应予重视；临床诊断女性早发CHD应强调危险因素的综合评估。

    【关键词】 冠状动脉疾病；冠状动脉造影；危险因素；女性

    Gender gap in clinical and coronary features with premature coronary heart disease Wang Jijun, Huang Zhenyong, Jiang Shisen, Lv lei, Gong Jianbin ，Zhang Qigao，Peng Yongping，He Songqing， Wang Chunhui，Lin Xin。Department of Cardiology, Nanjing General Hospital of Nanjing Command, Nanjing 210002,China

    【Abstract】 Objective To characterize the clinical profiles, risk factors and coronary lesion in women with premature coronary heart disease(CHD).Methods A total of 753 consecutive women with premature CHD(≥50% luminal stenosis angiographically)were divided into female group(younger than 65 years, n=246) and male group(younger than 65 years, n=507).their risk factors including diabetes, dyslipidemia and hypertension, and coronary characteristics were compared.Results When compared with the male group, the female group with premature CHD had a similar age, a higher prevalence of diabetes(33.74% vs 19.13%,P<0.01).There were no significant differences in the prevalence of dyslipidemia, hypertension and the number of risk factors. Myocardial infarction(MI) was more prevalent among women(67.47% vs 52.66%, P<0.05).All patients with single branch stenosis accounted for 49.14%.The incidence of left anterior descending branch(LAD) stenosis was 70.65%.Two groups showed no significant differences in angiographical findings in terms of involved branches, the location and the severity of coronary lesion(P>0.05).Conclusion Women with premature CHD do not features a benign coronary lesion, as usually we think. The comprehensive assessment of risk factors is important in the accurate diagnosis of female premature CHD. ......