青年与老年急性心肌梗死患者的临床特点及冠脉病变严重程度比较  

Comparison of clinical characteristics and severity of coronary lesions between young and aged patients with acute myocardial infarction

作　　者：王萍[1] 郑茵[1] 曾敏[1] 蒙绪卿[1] 符秀虹[1] 何扬利[1] 陈积雄[1] WANG Ping ZHENG Yin ZENG Min MENG Xu-qing FU Xin-hong HE Yang-li CHEN Ji-xiong(Medical Health Care Center, People＇s Hospital of Hainan Province. Haikou, Hainan, 570311, China)

机构地区：[1]海南省人民医院医疗保健中心三区,海南海口570311

出　　处：《心血管康复医学杂志》2017年第3期238-241,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：2012年国家自然科学基金项目(81100153)~~

摘　　要：目的:探讨青年与老年急性心肌梗死(AMI)患者的临床特点及冠脉病变严重程度。方法:随机选择2014年10月至2016年4月在我院住院的青年AMI患者60例为青年组,老年AMI患者60例为老年组。分析比较两组患者的一般资料、临床特征、冠脉病变程度及住院期间不良事件发生率。结果:与老年组比较,青年组男性(75.0%比100.0%)、吸烟(43.33%比76.67%)、冠心病家族史(18.33%比46.67%)及肥胖比例(30.00%比53.33%)显著升高,高血压(63.33%比33.33%)和2型糖尿病比例(50.00%比13.33%)显著降低(P<0.05或<0.01);明确诱因(30.0%比60.0%)、典型胸痛(58.33%比86.67%)及ST段抬高型心肌梗死(STEMI)比例(43.33%比76.67%)显著升高;陈旧性心肌梗死史(13.33%比0)、不典型胸痛及非ST段抬高型心肌梗死(NSTEMI)比例显著降低(P均<0.01);单支病变(18.33%比63.33%)、中度狭窄比例(16.67%比40.00%)显著升高,多支病变(61.67%比20.00%)、重度狭窄比例(45.00%比20.00%)显著降低(P均<0.01)。与老年组比较,青年组住院期间主要不良心血管事件发生率(88.33%比13.33%)显著降低,P=0.001。结论:与老年患者比较,青年急性心肌梗死患者症状及心电图表现均较典型,血管病变范围局限,并发症少,早期干预预后较好。Objective： To explore clinical characteristics and severity of coronary lesions in young and aged patients with acute myocardial infarction （AMI）. Methods： A total of 60 young AMI patients and 60 aged AMI patients hos- pitalized in our hospital from Oct 2014 to Apr 2016 were randomly selected as youth group and aged group respectively. General data, clinical characteristics, coronary lesion severity and incidence of adverse events during hospi- talization were analyzed and compared between two groups. Results： Compared with aged group, there were signifi- cant rise in percentages of male （75.0% vs. 100.0%）, smoking （43.33% vs. 76.67%）, family history of CHD （18.33% vs. 46.67% ） and obesity （30.00% vs. 53.33 %） ; and significant reductions in percentages of hypertension （63.33% vs. 33.33%） and type 2 diabetes mellitus （50.00% vs. 13.33%）, P〈0.05 or 〈0.01; significant rise in percentages of clear causes （30.0% vs. 60.0%）, typical chest pain （58. 33% vs. 86.67%） and STEMI （43.33% vs. 76.67%）, significant reductions in percentages of old myocardial infarction history （13.33% vs. 0）, atypical chest pain and NSTEMI, P〈0.01 alh significant rise in percentages of single-vessel disease （18.33% vs. 63.33%）, medium stenosis （16. 67% vs. 40.00%）, and significant reductions in percentages of multi-vessel disease （61.67% vs. 20.00%） and severe stenosis （45.00% vs. 20.00%） in youth group, P〈0. 01 all. Compared with aged group, there was significant reduction in incidence rate of major adverse cardiovascular events （88.33% vs. 13.33%） in youth group during hospitalization, P = 0. 001. Conclusion： Compared with aged patients, the symptoms and ECG mani- festations are more typical, vascular lesion range is limited, and complications are few in young AMI patients.

关 键 词：青年人 老年人 心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病]