40年来北京地区急性心肌梗死患者人口学特征、危险因素和诱发因素变化分析  

Variations of Demography, Risk Factors and Triggering Factors for Acute Myocardial Infarction Patients in Beijing Area Over Recent 40 Years

作　　者：赵庆豪 许海燕[1] 杨跃进[1] 陈在嘉[1] 董秋婷[1] 李卫[2] 于宏伟 ZHAO Qing-hao;XU Hai-yan;YANG Yue-jin;CHEN Zai-jia;DONG Qiu-ting;LI Wei;YU Hong-wei(Department of Cardiology, National Center for Cardiovascular Disease and Fuwai Hospital, CAMS and PUMC, Beijing （100037）, China)

机构地区：[1]北京协和医学院中国医学科学院国家心血管病中心阜外医院冠心病诊治中心,北京市100037 [2]北京协和医学院中国医学科学院国家心血管病中心阜外医院医学统计研究中心,北京市100037

出　　处：《中国循环杂志》2018年第4期317-321,共5页Chinese Circulation Journal

基　　金："十二五"国家科技支撑计划(2011BAI11B02)

摘　　要：目的:分析20世纪70年代(以下简称1970s)和21世纪10年代(以下简称2010s)近40年,北京地区急性心肌梗死(AMI)患者人口学特征、危险因素和诱发因素的变化情况。方法:1970s组数据来源于北京地区防治冠心病协作组于1972-01至1973-12间登记的1 314例AMI患者,2010s组数据来源于中国AMI注册登记(CAMI)研究2013-01-01至2014-09-30期间北京地区入选的2 200例AMI患者。比较两组患者的人口学特征(包括性别、年龄和农民比例)、危险因素和诱发因素方面差异。结果:与1970s组相比,2010s组AMI患者中>70岁患者比例(15.8 %vs 25.6%,P<0.001)、男性比例(68.3% vs75.6%,P<0.001)和农民比例(6.5%vs 14.5%,P<0.001)均增加。与1970s组相比,2010s组AMI患者中既往卒中史(6.2% vs 10.5%,P<0.001)、既往心肌梗死史(9.5% vs 11.9%,P<0.05)及合并糖尿病比例(6.2% vs 27.6%,P<0.001)明显升高。与1970s组相比,2010s组由于精神应激的AMI患者比例降低(51.1% vs 15.2%,P<0.001)、体力应激诱发的AMI患者比例增高(40.0% vs 61.1%,P=0.007)。结论:近40年,北京地区AMI患者的年龄、性别、农民比例,卒中史、心肌梗死史及糖尿病患者比例发生了巨大的变化,呈现老龄化、男性化、农村化的趋势,体力应激和不良的生活方式是当代AMI的主要诱发因素。对此变化趋势应开展更有针对性的心脏病预防和教育项目。Objectives： To analyze the variations of demography, risk factors and triggering factors in acute myocardial infarction （AMI） patients in Beijing area over recent 40 years from 1970s to 2010s. Methods： Our research included in 2 groups： 1970s group, 1314 patients from Beijing collaborative group of coronary artery disease prevention and treatment from 1972-01 to 1973-12; 2010s group, 2200 patients from China AMI registry in Beijing area from 2013-01-01 to 2014-09-30. Demographic characteristics including gender, age, farmer proportion, risk factors and triggering factors for AMI occurrence were compared between 2 groups. Results： Compared with 1970s group, 2010s group had more patients〉70 years of age （15.8% vs 25.6%, P〈0.001）, more with male gender （68.3% vs 75.6%, P〈0.001） and the higher farmer proportion （6.5% vs 14.5%, P〈0.001）; 2010s group showed more patients with previous histories of stroke （6.2% vs 10.5%）, MI （9.5% vs 11.9%） and diabetes mellitus （DM） （6.2% vs 27.6%）, all P〈0.05; 2010s group presented that less patients were triggered by mental stress （51.1% vs 15.2%, P〈0.001）, while more were induced by physical stress （40.0% vs 61.1%, P=0.007）. Conclusions： There were significant changes in recent 40 years for AMI patients in terms of age, gender, farmerproportion, previous histories of stroke, MI and DM; it appeared as aging, androphany and ruralized trends. Physical stress and unhealthy lifestyle were the major triggering factors for AMI occurrence nowadays, more specific efforts should be conducted for heart disease prevention and education.

关 键 词：心肌梗死 危险因素 诱发因素 

分 类 号：R54[医药卫生—心血管疾病]