青年与老年冠心病患者危险因素及病变特点对比分析  

Comparison of risk factors and coronary artery lesions between young and elderly patients with coronary heart disease

作　　者：李志立[1] 杨欣国[1] 王毅[1] 张录兴[1] 金葵花[1] 吴学勤[1] 

机构地区：[1]第四军医大学唐都医院心内科,陕西西安710038

出　　处：《心脏杂志》2009年第4期511-513,共3页Chinese Heart Journal

摘　　要：目的比较青年与老年冠心病患者危险因素及病变特点。方法选择冠状动脉造影确诊的冠心病患者213例。老年组132(男108,女24)例;青年组81(男77,女4)例。回顾性分析危险因素及冠状动脉病变特点,支架植入资料。结果①两组中,吸烟、高三酰甘油血症、高血压是前三位的危险因素。青年组的严重超重率及高血压显著高于老年组(38%vs12%和46%vs21%,P<0.05)。②青年患者冠状动脉双支以上病变率显著低于老年组(53%vs73%,P<0.05)。青年和老年患者,严重超重者的冠状动脉血管双支病变率高达74%和94%,前降支病变分别占48%和40%。③老年组植入支架率显著高于青年组(85.9%vs56.8%,P<0.01)。④青年患者的急诊住院率显著高于老年组(37.0%vs12.1%,P<0.05)。结论吸烟、高三酰甘油血症、高血压病是前三位的危险因素,严重超重及高血压病在青年患者发病中起重要作用。长期吸烟和酗酒的老年患者,冠状动脉病变严重。青年患者发病突然,老年患者冠状动脉病变较重。约半数患者病变累及左前降支。AIM： To compare the risk factors and the coronary artery lesions between young and elderly patients with coronary heart disease. METHODS： One hundred thirty two elderly patients and 81 young patients were identified as coronary heart disease by coronary angiography. The risk factors, coronary artery lesions and the results of stents were analyzed. RESULTS： 1 ） Smoking, hyperlipdemia and hypertension were the top three risk factors. The percentage of overweight in young patients was significantly higher than in elderly patients （38% vs. 12% ） （P 〈 0.05 ）. 2） The percentage of patients with more than two lesions in young patients was significantly lower than in elderly patients （53% vs. 72% ） （P 〈 0.05） and was 74% and 94% in overweigh patients, respectively. Left descending artery （LAD） lesions were 48% and 41% , respectively. 3） The percentage of stent-planting in elderly patients was significantly higher than in young patients （85.9% vs. 56.8% ） （P 〈0.01 ）. 4） The percentage of hospitalization from the emergency department was significantly higher in young patients （37% vs. 12% ） （P 〈 0.05）. CONCLUSION： Smoking, hyperlipdemia and hypertension are the top three risk factors for coronary heart diseases. Overweight and hypertension are also important factors in young patients. The lesions are serious in elderly patients with a long history of smoking and alcohol consumption. Elderly patients suffer from more serious lesions, and the lesions in about half of them involve LAD. Young patients tend to have an abrupt onset of coronary heart disease.

关 键 词：青年 冠状动脉疾病 危险因素 支架 

分 类 号：R541.4[医药卫生—心血管疾病]