不同类型老年急性心肌梗死患者的临床特点比较

目的探讨不同类型老年急性心肌梗死患者的临床特点及血运重建状况。方法对比分析262例ST段抬高心肌梗死(STEMI)患者(STEMI组)和189例非ST段抬高心肌梗死(NSTEMI)患者(NSTEMI组)的临床特点,冠状动脉病变及院内血运重建情况。结果与NSTEMI组比较,STENM1组患者男性比例多,平均年龄相对偏小,典型胸痛症状比例高,血肌酸激酶和肌酸激酶同工酶明显高,差异有统计学意义(P<0.05)。而NSTEMI组患者伴有高血压、血脂异常和2型糖尿病比例多,差异有统计学意义(P<0.05)。NSTEMI组多支血管病变、弥漫病变、≥90%严重狭窄的梗死相关动脉(IRA)比例、IRA闭塞的侧支循环开放率均明显高于STEMI组(P<0.05,P<0.01);而IRA完全闭塞率低于STEMI组,差异有统计学意义(P<0.01)。NSTEMI组住院期间血运重建率显著低于STEMI组,差异有统计学意义(P<0.01)。2组院内主要不良心脏事件发生率类似。结论老年NSTEMI患者临床合并症较多,冠状动脉病变较重,血运重建比例低。

Comparison of clinical characteristics in the aged with different types of acute myocardial infarction

Objective To compare the clinical feature and revascularization status in the aged with different types of acute myocardial infarction.Methods The patients with acute myocardial infarction were ddivided into two groups:ST-elevation myocardial infarction(STEMI) group and non-ST-elevation myocardial infarction(NSTEMI) group.The clinical and coronary angiographic characteristics and revascularization status were compared.Results In the STEMI group,the proportion of males,rate of typical chest pain,peak value of CK and CK-MB were higher than those in NSTEMI group(P<0.05);but in NSTEMI group,the patients were elder,the rates of hypertension, hyperlipemia and diabetes were higher(P<0.05).Multi-vessel diseases of coronary artery, long stenotic lesion,≥90%severe stenosis of infarction-related artery(IRA),collateral circulation of IRA were more prevalent in the NSTEMI group(P<0.05,P<0.01).The rate of IRA total obstruction was significantly lower in the NSTEMI group than in the STEMI group(P<0.01).During hospital stay,the rate of revascularization in the NSTEMI group was lower than that in STEMI group(P<0.01),but the rate of MACCE was same between the two groups.Conclusion Compared with the aged with STEMI,the NSTEMI group has more clinical complications,more severe coronary lesions,less revascularization.