老年冠心病患者冠状动脉病变特点及相关危险因素分析  

Features and isk factors of coronary artery lesion in elderly patients with coronary heart disease

作　　者：张萍[1] 李晓玉[1] 楚卡琳[1] 宋丽清[1] 范丽雯[1] 康健[1] 赵兴山[1] 

机构地区：[1]北京积水潭医院内科,100035

出　　处：《中国综合临床》2007年第9期769-771,共3页Clinical Medicine of China

基　　金：北京市卫生局十百千资助项目

摘　　要：目的观察老年冠心病患者(包括高龄老年患者)冠状动脉影像学特点和临床特征,分析老年冠心病各危险因素与冠状动脉病变程度的相关性。方法选择冠状动脉造影确诊为冠心病的患者280例.按年龄不同分为3组:中年组(<60岁),普通老年组(60岁≤年龄<75岁),高龄老年组(≥75岁)。所有患者均在入院后测定空腹血糖、血脂、尿酸等生化指标;测量身高、体重;调查既往史;同期行冠状动脉造影及超声心动图检查。冠状动脉狭窄程度根据美国心脏协会(AHA)1975年分类标准评价,冠状动脉的危险因素应用Spearman相关分析。结果①普通与高龄老年组冠状动脉积分较中年组高,高龄老年组最明显(P<0.01);普通与高龄老年组右冠状动脉(RCA)病变比例均升高,高龄老年组右冠状动脉积分高于普通老年组(P<0.05)。②普通与高龄老年组左心室射血分数(LVEF)均较中年组明显减低(P<0.05),高龄老年组比普通老年组更低(P<0.05)。③年龄、左心室质量指数、左心室射血分数、空腹血糖水平、低密度脂蛋白胆固醇水平及高血压、糖尿病、心肌梗死病史与冠状动脉积分明显相关。结论老年冠心病患者冠状动脉病变广泛而严重,且心功能差,高龄老年患者更明显;年龄因素不可控制,因此积极干预其他危险因素如高血压、糖尿病、高血脂等甚为重要。Objective To study the imaging characteristics and clinical features of coronary artery changes in elderly patients of coronary heart disease as well as to analyze the correlation between related risk factors and the severity of coronary lesion. Methods 280 cases were divided into three groups according to the ages ： Middle-age group （ 〈 60 years old ）, Elderly group （ 60 ≤ ages 〈 75 years old ） , Advanced-age group （ ≥ 75 years old ）, The fasting blood glucose, lipid, and uric acid were detected, Height and weight were measured, Past history was investigated, Coronary angiography and ECG were performed, The severity of coronary artery stenosis was evaluated by AHA standards ;the related risk factors were analyzed by Spearman＇s statistics, Results The higher coronary artery scores and abnormal RCA and lower LVEF were all found in elderly group and advanced-age group,especially in the later;A significant positive correlation was also showed between the coronary artery scores and aging, LVMI, LDL-C, diabetes mellitus,myocardial infaretion,hypertension. Conclusion The patients in the elderly group and advanced-age group have severe and extentive coronary artery lesion. It is important to control the related risk factors in the intervention and prevention of coronary heart disease.

关 键 词：冠状动脉疾病 冠状血管造影术 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]