老年与非老年急性心肌梗死的冠状动脉病变及心功能变化的比较研究  

A STUDY OF COMPARISON OF CORONARY ARTERY LESIONS AND VENTRICULAR PER-FORMANCE FOR AGED AND NON - AGED ACUTE MYOCARDIAL INFARCTION

作　　者：彭风芹[1] 刘君[2] 傅向华[2] 马宁[2] 吴伟力[2] 李世强[2] 谷新顺[2] 李亮[2] 苗青[2] 姜云发[2] 

机构地区：[1]峰峰矿务局总医院心内科 [2]河北医科大学第二医院干部病房,河北省石家庄市050000

出　　处：《中国心血管病研究》2003年第2期106-109,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 比较老年人与非老年人急性心肌梗死的冠状动脉(冠脉)病变特点及其左心室收缩、舒张和收缩同步性功能的变化。方法 连续入院的168例急性心肌梗死患者,其中老年患者52例,非老年患者116例,于梗死后72h内行定量冠脉造影(CAG),1周后行平衡法核素心室造影(ERNA)和心室相位分析(PA),测定左室功能参数。结果 ①老年组中有糖尿病、陈旧心肌梗死、反复心绞痛发作的比率显著高于非老年组(30.77％vs 10.34％;34.62％vs 14.66％;61.54％vs 24.14％,均P<0.01),而Q波梗死发生率低于非老年组,且CK和CK-MB峰值分别较非老年组低55.33％和58.60％(P<0.05)。②老年组多支病变、90％-99％严重狭窄、C型病变和梗死相关血管(IRA)TIMI-Ⅲ级血流均高于非老年组(P<0.05),而急性室壁瘤形成率低于非老年组(3.85％vs 23.28％,P<0.01)。③老年组心室舒张功能参数PFR较非老年组低7.36％(P<0.01),TPFR较非老年组明显延长4.75％(P<0.01),心室收缩同步性功能参数PS、FWHM、PSD分别明显低于非老年组15.05％、15.84％、27.04％(P<0.01)。结论 老年多支复杂血管病变明显高于非老年并伴有明显的舒张功能减退;非老年患者IRA完全闭塞率和急性室壁瘤发生率均高于老年患者,并伴有严重的心室收缩同步性降低。Objective To compare the characteristic of coronary artery lesions and ventricular systolic, diastolic and synchronous function of aged acute myocardial infarction and non-aged acute myocardial infarction in Chinese. Methods 168 consecutive patients(aged acute myocardial infarction 52 and non -aged acute myocardial infarction 116) were enrolled into the study. Coronary angiography (CAG) was performed within 72 hours in all patients, while the parameters of left ventricular function were measured by equilibrium radionuclide angiography(ERNA) with ventricular phase analysis(PA) within 1 week after acute myocardial infarction. Results ⅠThe incidences of patients associated with diabetes and old myocardial infarction in aged acute myocardial infarction group were higher than those of that in non - aged acute myocardial infarction group(30. 77% vs 10. 34%; 34. 62% vs 14. 66%; 61.54% vs 24.14%,P<0. 01),The peak value of CK and CK-MB in aged acute myocardial infarction group were reduced by 55.33% and 58. 60% (P<0. 05)as compared with those in non- aged a-cute myocardial infarction group, individually. ⅡThe incidences of multi - vessel lesions, 90%-99% stenosis, C - type lesions, TIMI - Ⅲ-grade of collateral circulation and TIMI - Ⅲ - grade of IRA in aged acute myocardial infarction group were higher than those in non - aged acute myocardial infarction group (P<0. 05), respectively, but the incidences of acute ventricular aneuryzm were lower in aged a-cute myocardial infarction group than those in non- aged acute myocardial infarction group(3.85% vs 23.28%, P<0.01), respectively. ⅢThe ventricular diastolic function parameters PFR in aged acute myocardial infarction group was decreased by 7. 36% (P< 0. 01)and TPFR was increased by 4. 75% (P<0.01) as compared with those in non- aged acute myocardial infarction group. The ventricular systolic synchrony(VSS) parameters PS, FWHM and PSD in aged acute myocardial infarction group were reduced by 15.05 % , 15.84 % and 27.04 % ( P< 0.01) as compared with those in non -

关 键 词：老年人 急性心肌梗死 冠状动脉病变 心功能 心室 心绞痛 

分 类 号：R542.22[医药卫生—心血管疾病]