世居高原藏族急性ST段抬高型心肌梗死患者的冠状动脉病变特点和短期预后分析  

Coronary artery lesion characteristics and short-term prognosis analysis of patients with acute ST-segment elevation myocardial infarction in native Tibetans

作　　者：央金 格桑罗布[1] 古桑拉姆[1] 格桑嘎瓦[1] 伍满燕 YANG Jin;Gesangluobu;Gusanglamu;Gesanggawa;WU Man-yan(Department of Cardiology,People’s Hospital of Tibet Autonomous Region,Lhasa 850000,China)

机构地区：[1]西藏自治区人民医院高原病心血管内科,西藏拉萨850000 [2]北京大学人民医院心血管内科

出　　处：《中国介入心脏病学杂志》2021年第6期329-332,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的通过比较高原地区世居藏族和移居汉族急性ST段抬高型心肌梗死(STEMI)患者的危险因素、冠状动脉病变特点和短期预后结果,旨在为高原STEMI的防治提供临床依据。方法回顾性分析2017年1月至2020年8月西藏自治区人民医院收治的STEMI患者177例,通过查阅病历如实记录患者社会人口学、危险因素、发病情况、实验室结果、住院治疗情况和住院不良事件结局等,并由两名心血管介入医师独立判读冠状动脉造影(CAG)图像,比较两组患者的危险因素、冠状动脉病变特点和短期预后。结果共纳入世居藏族STEMI患者112例(世居藏族组)、移居汉族STEMI患者65例(移居汉族组);世居藏族组的平均年龄为(59.5±12.2)岁,显著大于同时期的移居汉族组[(47.9±11.3)岁,P<0.001],均以男性为主(分别占91.1%和90.8%)。世居藏族组合并高血压病比例(56.3%比29.2%)、GRACE评分[116.5(92.0,142.5)分比99.0(79.0,128.0)分]、CRUSADE评分[25.0(19.0,35.0)分比21.0(15.0,28.0)分]更高(均P<0.05),血红蛋白水平[(169.7±24.2)g/L比(182.5±24.7)g/L,P<0.05]更低。两组患者冠状动脉病变特征、严重程度、血运重建治疗比例和短期预后比较,差异均无统计学意义(均P>0.05)。结论与移居汉族STEMI患者相比,世居藏族STEMI患者的年龄更大,且入院时缺血和出血危险分层更高,但在冠状动脉病变特点和血运重建治疗相似的情况下,短期预后无明显差异。Objective The risk factors,coronary artery lesion characteristics and short-term prognosis were compared between patients with acute ST-segment elevation myocardial infarction(STEMI)in native Tibetans and immigrants Han,aiming to provide clinical evidence for prevention and treatment for high-altitude STEMI.Methods A total of 177 STEMI patients admitted to the People's Hospital of Tibet Autonomous Region from January 2017 to August 2020 were retrospectively analysed.The social demography characteristics,risk factors,comorbidity,laboratory results,hospitalization results,and hospitalization adverse events and outcomes were recorded based on medical records.Two cardiovascular interventional physicians independently interpreted coronary angiography(CAG)images to analyze and compare the risk factors,coronary artery lesion characteristics and short-term prognosis of the two groups of patients.Results A total of 112 STEMI patients of native Tibetans and 65 STEMI patients of Han immigrants were enrolled.The mean age of the native Tibetans group was(59.5±12.2)years old,which was significantly older than the immigrant Han group[(47.9±11.3)years old,P<0.001].Most of them were male(91.1%and 90.8%,respectively).Compared with immigrant Han,the proportion of hypertension(56.3%vs.29.2%),GRACE score[116.5(92.0,142.5)points vs.99.0(79.0,128.0)points],and CRUSADE score[25.0(19.0,35.0)points vs.21.0(15.0,28.0)points]were higher in native Tibetans(all P<0.05),while the hemoglobin level[(169.7±24.2)g/L vs.(169.7±24.2)g/L]was lower(P<0.05).The characteristics and severity of coronary artery lesions,coronary revascularization and short-term prognosis were not different between the two groups(all P>0.05).Conclusions Compared with immigrant Han,native Tibetans are older and have higher risk stratification of ischemia and hemorrhage on admission,but there is no significant diff erence in short-term prognosis,and the characteristics of coronary lesions and revascularization therapy are similar.

关 键 词：高原 心肌梗死 危险因素 预后 

分 类 号：R542.2[医药卫生—心血管疾病]