不同年龄段急性心肌梗死患者的临床特点及预后  

Clinical characteristics and outcomes of acute myocardial infarction patients in different age groups

作　　者：胡龙[1] 单培仁[1] 周昌钻 周晓东 陈婵婵[1] 黄伟剑[1] HU Long;SHAN Peiren;ZHOU Changzuan(Department of Cardiology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第一医院心内科,325000

出　　处：《心电与循环》2020年第3期242-246,共5页Journal of Electrocardiology and Circulation

基　　金：国家自然科学青年基金项目(81600341);浙江省自然青年基金项目(LQ15H020005);温州市科技局项目(Y20160307)。

摘　　要：目的探讨不同年龄段急性心肌梗死患者的危险因素、冠状动脉病变特点及预后。方法回顾性分析急性心肌梗死患者1328例,根据患者年龄分为3组:青年组(<45岁)、中年组(45~75岁)、老年组(>75岁),分析并比较3组患者的临床特点、造影结果及随访3年结果。结果青年组男性比例、吸烟率、体重指数(BMI)、低密度脂蛋白胆固醇(LDL-C)水平均高于中年组和老年组(P<0.05或0.01),高血压比例老年组高于青年组和中年组(均P<0.01),3组糖尿病比例差异无统计学意义(P>0.05)。冠状动脉造影结果显示年龄越轻越倾向于单支冠状动脉病变,老年组冠状动脉则倾向于多支病变(P<0.01)。院内、随访1个月及3年死亡率均随着年龄增加而增加(均P<0.01)。结论吸烟、高BMI及高LDL-C血症是年青人心肌梗死的主要危险因素。老年人冠状动脉病变重,预后差。Objective To assess the risk factors,coronary angiographic findings and prognosis of acute myocardial infarction(AMI)patients in different age groups.Methods The data of 1328 AMI patients were reviewed.They were divided into young group(<45 years),middle aged group(45~75 years)and elderly group(>75 years).The clinical characteristics,coronary angiographic findings and prognosis during 3 years follow-up were analyzed and compared between groups.Results The ratio of male,the incidence of smoker,the body mass index(BMI)and LDL-C level were significantly higher in young group than in middle aged group and elderly group(P<0.05 or 0.01).The incidence of hypertension was significantly higher in elderly group than in young group and middle aged group(all P<0.01).There was no significant difference of diabetes mellitus among three groups(P>0.05).Coronary artery angiography showed that single vessel disease was seen more in young group and multivessel lesion in elderly group(P<0.01).The mortality of in-hospital,at one month and 3 years follow up increased with age increase(all P<0.01).Conclusion Smoking,high BMI and high LDL-C are main risk factors of AMI in younger.Elderly patients have severe coronary lesions and poor prognosis.

关 键 词：急性心肌梗死 急诊冠状动脉介入 年龄 预后 

分 类 号：R542.22[医药卫生—心血管疾病]