青年与老年冠状动脉慢血流患者临床特点对比研究  

Comparative Study on Clinical Characteristics of Young and Elderly Patients with Slow Coronary Flow

作　　者：韦伟 李巍 贾宁[1] 佟海锋 杜大勇 石丽威 刘畅[1] WEI Wei;LI Wei;JIA Ning;TONG Haifeng;DU Dayong;SHI Liwei;LIU Chang(Department of General Medicine(General Practice Medicine),Eastern Medical Branch of PLA General Hospital,Beijing 101149,China;Department of Cardiology,the 305th Hospital of People's Liberation Army of China,Beijing 100017,China)

机构地区：[1]中国人民解放军总医院京东医疗区综合内科(全科医学科),北京市101149 [2]中国人民解放军第三〇五医院心内科,北京市100017

出　　处：《中国全科医学》2024年第30期3753-3757,共5页Chinese General Practice

摘　　要：背景冠状动脉慢血流(CSF)现象表现为反复发作的静息型心绞痛,可能会导致急性心肌梗死、致命性的心律失常和心源性猝死等严重的心血管事件,并降低患者的生活质量。随着冠状动脉造影(CAG)的安全性、可行性、可靠性的提高,CSF的检出率逐渐增高,但国内外对早发CSF机制、青年CSF患者的临床特点对比分析较少。目的初步探讨青年CSF患者的临床特点,并与老年CSF患者相比较,为探索早发CSF机制提供方向与思路。方法连续性分析2017年1月—2019年1月在中国人民解放军第三〇五医院心内科住院经CAG诊断为CSF的青年(18岁≤年龄<45岁)患者86例作为青年组,随机抽取同期≥65岁的CSF患者88例作为老年组。收集整理两组患者的临床资料,包括病史、诊断,以及实验室相关检查和CAG结果,进行对比分析。结果青年组患者平均年龄、高血压比例、糖尿病比例低于老年组,男性比例、BMI高于老年组(P<0.05)。青年组患者CSF累及血管支数以单支为主(58.1%),老年组患者CSF累及血管支数以三支为主(45.5%);两组患者CSF累及血管支数分布比较,差异有统计学意义(χ^(2)=29.521,P<0.001)。青年组患者CSF累及血管总数为137个,老年组患者CSF累及血管总数为199个;两组患者CSF累及血管分布比较,差异无统计学意义(χ^(2)=1.366,P=0.644)。青年组患者三酰甘油(TG)、血尿酸(SUA)、高敏C反应蛋白(hs-CRP)、内皮素1(ET-1)水平高于老年组,一氧化氮(NO)水平低于老年组(P<0.05)。结论与老年CSF患者相比,青年CSF患者中男性多,BMI高,CSF累及血管个数少,TG、SUA、hs-CRP、ET-1水平较高,而高血压、糖尿病比例较低。提示代谢异常、炎症反应以及血管内皮功能受损与青年CSF的发病更为密切相关。Background The phenomenon of coronary slow flow(CSF)is characterized by recurrent angina pectoris,which may lead to acute myocardial infarction,fatal arrhythmia and sudden cardiac death,and reduce the quality of life of patients.With the improvement of the safety,feasibility and reliability of coronary angiography(CAG),the detection rate of CSF increased gradually.However,there are few studies on the mechanism of early-onset CSF and clinical characteristics of young patients with CSF.Objective To explore the clinical characteristics in young patients with CSF and compare them with the elderly patients in order to provide its pathogenesis.Methods Continuity analysis from January 2017 to January 2019,86 young patients(18 years≤age<45 years)diagnosed with CSF by CAG in the Department of Cardiology at the 305th Hospital of the People's Liberation Army of China were selected as young group,and 88 CSF patients≥65 years old during the same period were randomly selected as elderly group.Collect and organize clinical data of two groups of patients,including medical history,diagnosis,laboratory tests,and CAG results,for comparative analysis.Results The results showed that the young group had lower average age、hypertension ratio and diabetes ratio than those in elderly group,while the male ratio and BMI were higher than those in elderly group(P<0.05).The number of coronary vascular branches involved in CSF in young group was mainly single branch(58.1%),while in elderly group,the number of vascular branches involved in CSF was mainly three(45.5%);There is a statistically significant difference in the distribution of blood vessel branches involved in CSF between two groups of patients(χ^(2)=29.521,P<0.001).The total number of blood vessels affected by CSF in young group was 137,while in elderly group,the total number of blood vessels affected by CSF was 199;There is no statistically significant difference in the distribution of blood vessels involved in CSF between two groups of patients(χ^(2)=1.366,P=0.644).The level

关 键 词：冠状动脉慢血流 临床特点 青年人 老年人 对比研究 

分 类 号：R543.3[医药卫生—心血管疾病]