青年与老年急性心肌梗死患者的临床分析  

Clinical analysis of the characteristics of AMI in the young and in the elderly

作　　者：方雪花[1] 余清[1] 原红霞[1] 

机构地区：[1]北京市良乡医院心内科,102400

出　　处：《北京医学》2007年第2期78-80,共3页Beijing Medical Journal

摘　　要：目的探讨青年人急性心肌梗死(AMI)发病的特点,以及与老年人AMI的不同之处。方法对126例AMI患者行经皮冠状动脉介入治疗,其中青年人AMI46例;老年人AMI80例。收集病史资料,包括性别、高血压病史、吸烟史、糖尿病史、心血管家族史,入院后记录血生化(血糖、血脂)、血压以及并发症(心功能、心律失常),急诊或择期行冠状动脉造影,了解冠状动脉病变情况。结果青年组男性发病率为93.48%,明显高于女性的6.52%,吸烟率为95.65%,冠心病家族史为19.57%,均显著高于老年组的80.0%及6.25%;老年组高血压、高脂血症发病率为65.0%及46.25%,明显高于青年组的45.65%及23.91%;青年组心功能Ⅰ级者占58.7%,明显高于老年组的22.5%,而III级者青年组占6.52%,明显低于老年组的30.0%;青年组单支病变发生率为54.35%,明显比老年组的12.50%增多,三支病变少于老年组的57.50%;冠脉痉挛青年组为10.87%,高于老年组的1.25%。结论青年AMI男性高发,有吸烟史、高脂血症史易发生,尤其有冠心病家族史者,单支病变较多,并发症少,预后较老年组好。Objectives To evaluate the characteristics of acute myocardial infarction（AMI） in the young and in the elderly. Methods 126 cases who were performed for percutaneous coronary intervention （PCI） in Liangxiang Hospital of Beijing were included. There were totally 46 cases of AMI in the Young and 80 cases of AMI in the Elderly. The Data of the study included： gender, hypertension, smoking, diabetes mellitus and family history of cardiovascular disease. Clinical features included： blood sugar, lipid, blood pressure, complications （cardiac function, arrhythmia） and coronary angiography （CAG）. Results The occurrence of AMI in the young male （93.5%） was more common than that of the young females （6.5%） （P=0.0001）. The proportion of smoking and family history of cardiovascular disease （%）in the young were more than that in the elderly （P=0.001, P=0.022）. The proportion of hypertension, diabetes mellitus and hyperlipaemia in the eldly group were significantly higher than that of the young group. The number of cardiac function I of young group were more than that of the eldly group （P=0.0001）. Patients in the young group tended to have higher triglyceridemia than those in the old group （P=0.013）. Proportion of single vessel disease in the Young was significant more than that in Elderly（P=0.0013）. However, proportion of tri-vessel disease in the Young was significantly less than that in Elderly. Vascular spasm in the young group was more than old group （P=0.024）. Conclusions The occurrence of AMI in the young is more freguent in those who had smoking, hyperlipaemia, especially having the family history of positive coronary heart disease. AMI in the young patients tends to have more single vessel disease, lower complications and better prognosis than the eldly patients.

关 键 词：青年 老年 心肌梗死 临床特点 

分 类 号：R542.22[医药卫生—心血管疾病]