不同年龄组急性心肌梗死患者冠状动脉病变特点及危险因素分析

目的 研究不同年龄组急性心肌梗死(AMI)患者的危险因素及冠状动脉病变特点.方法 系统回顾性分析225 例不同年龄(分为青年组、壮年组、老年组)AMI 患者的危险因素及冠状动脉造影资料.结果 青年组AMI 危险因素以吸烟(与壮年组及老年组比较P＜0.05)及血脂异常为主;壮年组在此基础上增加高血压危险;老年组糖尿病是重要的危险因素.老年女性糖尿病发病率(35.1%)明显上升;梗死相关动脉狭窄程度各年龄组差异均有统计学意义(P＜0.05);临界病变(50%～75%狭窄)壮年组最多;重度狭窄(76%～95%狭窄)的概率随年龄增加而增加,分别为18.8%、38.4%和43.4%;成角和钙化病变老年组概率升高,与壮年组比较差异有统计学意义(P＜0.01).结论 吸烟、血脂异常、高血压、糖尿病等冠心病危险因素在不同年龄组男性和女性AMI 患者所占比重不同.随年龄增高,冠状动脉多支、复杂病变多见,不同年龄段应该采取相应的防治措施.

Analysis of coronary arterial lesion characteristics and risk factors in different age groups of patients with acute myocardial infarction

Objective To observe the risk factors and coronary arterial lesion characteristics in different age groups of patients with acute myocardial infarction （AMI）. Methods The risk factors and the data of coronary angiography in 225 patients with AMI who were divided into three groups （young, middle age and elderly） were analyzed retrospectively. Results In young group, the risk factors are smoking （compared with other group, P〈 0.05） and hyperlipidemia. And in middle age group, beside smoking and hyperlipidemia, hypertension is also one of the risk factors. However in elderly group, diabetes is the most important risk factor. The prevalence of diabetes in elderly female increased significantly（35.1%）. On the other hand, the severity of infarction related artery stenosis in each age group are significantly different （P〈0.05）. In middle age group, the proportion of border lesions （50% -75% stenosis） is higher than other groups. Severe stenosis （76%-95% stenosis） increases with age（ 18.8%, 38.4% and 43.4%, respectively）. Angulation and calcified lesions in aged group increased significantly compared with middle age group （P〈0.01）. Conclusion The prevalence of smoking, dyslipidemia, hypertension and diabetes are different in different age groups of AMI patients. With increased age, the coronary lesion became more mul- tiple and complicated. The prevention and management should be applied according to different age group.