不同性别老老年心肌梗死患者血脂水平及冠脉病变严重程度差异的分析

目的:探讨不同性别80岁及以上急性心肌梗死患者的血脂特点以及冠脉病变严重程度。方法:连续入选2012年1月-2017年12月于天津医科大学第二医院心脏科住院治疗的急性心肌梗死（包括STEMI和non-STEMI）患者（大于80岁）201人，其中男性组106例，平均年龄为（83.11±3.11）岁，女性组95例，平均年龄为（82.54±2.16）岁，依据冠状动脉造影进行Gensini评分，比较不同性别患者病史、血脂水平及病变严重程度。结果:老老年女性ACS患者的LDL（3.12±1.01 vs 2.71±1.03）、HDL（1.22±0.65 vs 1.00±0.30）、TC（4.75±1.37 vs 4.14±1.07）、TG（1.37±0.61 vs 1.00±0.42）均高于男性组，具有统计学意义（P＜0.05）。老老年男性ACS患者吸烟史（32.08% vs 17.89%），饮酒史（22.64% vs 0.03%）比率高于女性患者，具有统计学意义（P＜0.05），不同性别老老年心肌梗死患者的高血压及糖尿病患病率未见显著差异（P=0.178，P=0.499），冠脉造影Gensini评分结果显示老老年ACS患者血管病变严重程度并无显著差异（P=0.412）。结论:老老年心肌梗死患者病变严重程度并无明显差异,而血脂紊乱存在性别差异，男性患者血脂更为理想，对老老年冠心病的降血脂治疗需要依据患者性别合理用药。

Analysis of in blood lipid levels and severity of coronary lesions in elderly patients different genders with myocardial infarction

Objective: To investigate the characteristics of blood lipids in patients with acute myocardial infarction of 80 years and older and the relationship between serum lipid levels and severity of coronary artery disease in patients with acute myocardial infarction. Methods: A total of 201 patients (more than 80 years old) with acute myocardial infarction(including STEMI and non-STEMI) were enrolled in the Department of Cardiology, Second Hospital of Tianjin Medical University from January 2012 to December 2017, including 106 males. The mean age was 83.11±3.11 years, and the female group was 95 patients. The average age was 82.54±2.16 years. The Gensini score was based on coronary angiography. The medical history, blood lipid level and severity of the disease were compared. Results: LDL(3.12±1.01 vs 2.71±1.03), HDL(1.22±0.65 vs 1.00±0.30), TC(4.75±1.37 vs 4.14±1.07), TG(1.37±0.61 vs 1.00±0.42) in elderly women ACS 0.42) was higher than the male group and was statistically significant (P<0.05). Older male ACS patients had a history of smoking (32.08% vs 17.89%) and drinking history(22.64% vs 0.03%). Their results werehigher than female patients, with statistical significance(P<0.05). There was no significant difference in the prevalence of blood pressure and diabetes (P=0.178, P=0.499). The results of coronary angiography Gensini score showed no significant difference in the severity of vascular lesions in elderly ACS patients(P=0.412). Conclusion: There is no significant difference in the severity of lesions in elderly patients with myocardial infarction. There is a gender difference in dyslipidemia. Male patients have better blood lipids. The treatment of hypolipidemic disease in elderly patients with coronary heart disease needs to be carried out based on the patient’s gender.