不同性别老年ST段抬高性心肌梗塞患者临床分析

目的：探讨不同性别老年急性ST段抬高心肌梗塞（STEMI）患者冠状动脉病变程度以及危险因素的差异。方法：选择年龄≥60岁的STEMI患者206例,其中男性124例,女性82例,分析比较老年男性和女性STEMI患者临床基本资料,高血压、糖尿病、高脂血症、吸烟等危险因素伴发情况及冠状动脉病变程度。结果：与老年男性STEMI患者比较,老年女性STEMI患者总胆固醇（4.41±0.89）mmol/L∶（4.80±1.06）mmol/L]、高密度脂蛋白胆固醇（1.08±0.26）mmol/L∶（1.26±0.36）mmol/L]和低密度脂蛋白胆固醇（2.67±0.68）mmol/L∶（2.88±0.82）mmol/L]水平明显升高（P〈0.05~〈0.01）,合并糖尿病（25.0%∶39.8%）、高脂血症（36.3%∶52.4%）比例明显升高（P〈0.05~〈0.01）,女性STEMI患者冠状动脉病变积分较低（5.56±2.14）分∶（4.93±2.36）分,P〈0.05],三支病变比例明显降低（58.1%∶40.2%）,单支病变（15.3%∶26.8%）和双支病变（26.6%∶32.9%）比率明显升高（P均〈0.05）。结论：老年女性急性ST段抬高心肌梗塞患者较多合并高脂血症、糖尿病,而老年男性患者冠脉血管病变多为多支病变。

Clinical analysis of aged patients with ST elevation myocardial infarction and its gender different

Objective：To investigate difference of risk factors and severity of coronary artery lesions between male and female aged patients with acute ST elevation myocardial infarction（STEMI）.Methods：A total of 206 aged（≥60 years old） patients with STEMI were enrolled,including 124 men and 82 women.Clinical basic data,severity of coronary artery lesions and its risk factors such as hypertension,diabetes,hyperlipidemia and smoking of male and female aged patients with STEMI were compared and analyzed.Results： Compared with male aged patients with STEMI,levels of total cholesterol （4.41±0.89） mmol/L vs.（4.80±1.06） mmol/L],high density lipoprotein cholesterol （1.08±0.26） mmol/L vs.（1.26±0.36） mmol/L] and low density lipoprotein cholesterol （2.67±0.68） mmol/L vs.（2.88±0.82） mmol/L] significantly increased（P0.05~0.01）,ratio of complication of diabetes（25.0% vs.39.8%） and hyperlipidemia（36.3% vs.52.4%） significantly increased（P0.05~0.01）,coronary pathological changes score （5.56±2.14） scores vs.（4.93±2.36） scores,P0.05] was lower,proportion of three-vessel coronary disease（58.1% vs.40.2%） significantly decreased and proportions of single-vessel coronary disease（15.3% vs.26.8%） and double-vessel coronary disease（26.6% vs.32.9%） significantly increased in female aged patients with STEMI（P0.05 all）.Conclusion： Among aged patients with acute ST elevation myocardial infarction,women possess higher prevalence of hyperlipidemia and diabetes mellitus while most of men are with multi-vessel coronary disease.