海南老年和非老年急性心肌梗死患者冠状动脉病变造影分析

目的探讨海南老年和非老年急性心肌梗死患者冠状动脉病变特点。方法回顾性分析80例急性心肌梗死患者急诊冠状动脉造影结果。根据年龄分为两组：A组,年龄〈60岁,35例;B组,年龄≥60岁,45例。应用QCA软件测量和冠状动脉病变严重度积分法分析冠状动脉造影结果。结果①两组冠状动脉前降支（LAD）、回旋支（LCX）、右冠状动脉（RCA）3支血管发生病变概率相似（P〉0.05）,但B组左主干（LM）受累概率显著高于A组（2.9%vs13.3%,P〈0.05）;冠状动脉病变支数随年龄增加而增加（1.89±0.86vs2.32±0.92,P〈0.05）。②两组＂罪犯＂病变在LM、LAD、LCX和RCA分布差异无统计学意义（P〉0.05）。两组＂罪犯＂病变处狭窄程度有不同差异：临界病变（50%～75%狭窄）在两组中发生概率差异无统计学意义（2.9%vs4.4%,P〉0.05）;重度狭窄（76%～95%狭窄）发生概率随年龄增加而增加（20.0%vs46.7%,P〈0.05）;次全闭塞和完全闭塞病变的发生概率随年龄增加而减少（14.3%vs8.9%,P〈0.05;62.8%vs37.8%,P〈0.05）。两组急诊手术成功率差异无统计学意义（100%vs95.6%,P〉0.05）。结论海南老年和非老年急性心肌梗死患者冠状动脉病变存在不同特点,随年龄增长,老年心梗患者冠状动脉病变更趋复杂,但＂罪犯＂血管急诊手术成功率差异无统计学意义。

Analysis of coronary arteriogram with acute myocardial infarction in the gerontal and non-gerontal patients in Hainan province

Objective To analyze the coronary angiogram with acute myocardial infarction (AMI) in the gerontal and non-gerontal patients in Hainan province. Methods Eighty consecutive patients with AMI were divided into two groups by age: group A (<60 years, n=35) and group B (≥60 years, n=45). The coronary angiogram were compared between the two groups, by QCA software and the coronary severity score (CSS). Results The coronary lesion distribution between the two groups showed no significant difference in the left anterior descending (LADs), left circumflex (LCXs) and right coronary artery (RCAs) (P>0.05), except for left main coronary artery (LMs), which were more frequent in group B (3.3% vs 7.5%, P<0.05). The number of stenosis vessels (stenosis≥50%) increased significantly with age (1.89±0.86) vs (2.32±0.92), P<0.05). Between the two groups, no significant difference was found in the distribution of the culprit lesions in the LADs, LCXs, RCAs and LMs (P>0.05), while different was found in the stenosis degree of culprit lesions: the incidence of borderline lesion (50%~75% stenosis) were 2.9% vs 4.4% (P>0.05); the incidence of heavy stenosis (75%~95% stenosis) increased significantly with age (20.0% vs 46.7%, P<0.05). The incidences of subocclusion and acute total occlusion decreased significantly with age (79% vs 51.5%, P<0.05). There was no significant difference in the success rates of PCI between the two groups (P>0.05). Conclusion There are different characteristics of coronary lesion between the gerontal and non-gerontal patients in Hainan province. The coronary lesions tend to be more complicated with the increase of age, but no significant difference is found in the success rates of PCI.