不同年龄ST段抬高型心肌梗死患者的临床及冠状动脉造影特点研究  

Clinical and coronary angiographic characteristics of acute ST-segment elevation myocardial infarction in patients of different ages

作　　者：陈启[1] 陈韬[1] 朱荔[1] 李文文[1] 刘宇[1] 陈亮[1] 马丽萍[1] 赵仙先[1] 

机构地区：[1]第二军医大学附属长海医院心血管内科,200433

出　　处：《心电与循环》2015年第2期87-91,共5页Journal of Electrocardiology and Circulation

摘　　要：目的分析不同年龄急性ST段抬高型心肌梗死(STEMI)患者临床和冠状动脉造影特点。方法回顾分析在本院住院的STEMI患者的电子病历资料,比较青年组、中年组和老年组的危险因素、临床特点、实验室指标、心电图、冠状动脉造影结果及预后。结果共1 354例STEMI患者,其中青年组68例,中年组413例,老年组873例。青年组男性患者、吸烟、冠心病家族史、KillipⅠ级所占比例以及甘油三酯和血小板水平较老年组患者高,而高血压、室性心动过速/心室颤动、新发心房颤动,Killip IV级较老年组低,差异均有统计学意义(P<0.05),青年组冠状动脉造影"正常"和单支病变所占比例较中年组和老年组高,而后壁心肌梗死和三支病变较低(均P<0.05)。青年组死亡、心肌再梗死和再次PCI的发生率低于中年组及老年组患者(均P<0.05)。结论急性STEMI的危险因素、临床情况、冠状动脉造影特点及预后青年与中年和老年患者有较大不同,应针对这些特点进行治疗。Objective To analyze clinical and coronary angiographic features of ST- segment elevation myocardial infarction （STEMI） in patients of different ages. Methods The electric medical records of inpatients with STEMI from January 2007 to December 2013 in our hospital were reviewed. The risk factors,clincial characteristics, lab parameters, ECG, coronary angiography and prognosis were compared among young, middle- aged and elderly patients. Results 1354 inpatients with SETMI were enrolled. Of them, 68 cases were in young group, 413 cases in middle- aged group, and 873 cases in elderly group. Male, smoker, family history of coronary artery disease, Kil ip I, triglyceride and platelet count were significantly higher, while hypertension, ventricular tachycardia/fibril ation, new atrial fibrillation and Kil ip IV were lower in young group than elderly group （al P〈0.05）. Normal coronary angiography and single- vessel disease were seen more frequently, while posterior myocardial infarction and three- vessel disease were seen less frequently in young group than middle- aged and elderly groups. The prevalence of death, myocardial re- infarction and secondary PCI were lower in young group than middle- aged and elderly groups. Conclusion The risk factors,clincial characteristics, coronary angiography and prognosis of acute STEMI are different in young, middle- aged and elderly patients, which should be considered during management of STEMI.

关 键 词：ST段抬高型心肌梗死 危险因素 冠状动脉造影 预后 

分 类 号：R542.22[医药卫生—心血管疾病]