早发和老年急性心肌梗死发病特点的比较

目的:探讨早发急性心肌梗死(AMI)冠状动脉病变特点及其相关危险因素。方法:临床确诊为AMI的患者136例,根据年龄分为早发AMI组(男性<55岁,女性<65岁)55例,老年AMI组(男性≥55岁,女性≥65岁)81例,并进行危险因素、临床、生化及冠状动脉病变特点回顾分析,观察两组是否存在显著差异。结果:与老年AMI组相比,早发AMI组中男性、吸烟、冠心病家族史的比例显著升高(P<0.05或0.01)。临床生化检验显示,与老年AMI组比较,早发AMI组的血清总胆固醇[(4.28±1.03)mmol/L比(4.87±1.41)mmol/L]、甘油三酯[(1.22±0.66)mmol/L比(1.74±1.07)mmol/L]和载脂蛋白B[(0.80±0.18)g/L比(1.04±0.34)g/L]水平显著升高(P<0.05或0.01)。冠脉造影显示早发AMI组单支病变比例(27.3%)显著高于老年AMI组(11.1%)。早发AMI组冠脉病变程度Gensini积分显著低于老年AMI组[(58.70±27.11)分比(75.19±41.37)分,P<0.05]。结论:与老年急性心肌梗死患者比较,早发急性心肌梗死患者最常见的特征是男性,有吸烟、冠心病家族史者更多,血脂水平显著升高;且单支冠脉病变比例较高,冠脉狭窄程度显著较轻。

Comparison of morbidity characteristics between early-onset patients and aged patients with acute myocardial infarction

Objective： To compare morbidity characteristics between early-onset patients and aged patients with acute myocardial infarction （AMI）. Methods： According to age, a total of 136 patients diagnosed as AMI were divided into early-onset AMI group （male〈55 years old, female〈65 years old, n = 55） and aged AMI group （male≥55 years old, female≥65 years old, n = 81）. Clinical, biochemical and coronary lesion features were respectively analyzed in two groups to observe whether there was significant difference. Results.. Compared with aged AMI group, there were significant increase in percentage of males, smokers and patients with family history of coronary heart disease in early-onset AMI group （P〈0.05 or 0.01）. Compared with aged AMI group, there were significant increase in serum levels of total cholesterol [（4.28±1.03） mmol/L vs. （4. 87±1.41） mmol/L], triglyceride [（1.22±0.66） mmol/L vs. （1.74 ±1.07） mmol/L] and apolipoprotein B [ （0.80± 0.18） g/L vs. （1.04 ±0.34） g/L] in early-onset AMI group （P〈0.05 or 〈0.01）. Coronary angiography indicated that percentage of single vessel coronary disease in early-onset AMI group was higher than that of aged AMI group （27.3% vs. 11.1%）. Gensini score of early-onset AMI group was significantly lower than that of aged AMI group [ （58.70±27.11） scores vs. （75.19 ±41.37） scores, P〈0. 051. Conclusion： Compared with aged AMI, the percentage of male, smoking, with family history of coronary heart disease significantly increases, blood lipid levels significantly elevate, percentage of single vessel coronary disease is higher and stenotic degree of coronary disease is lower are common characteristics of earlyonset AMI.