老年与非老年急性心肌梗死危险因素及临床特点分析

目的探讨老年和非老年急性心肌梗死(AMI)的危险因素及临床特点差异。方法 312例初发AMI患者分为非老年组(年龄<60岁,n=124)和老年组(年龄≥60岁,n=188),比较分析两组间危险因素、临床表现、并发症及冠脉病变的特点。结果非老年组绝大多数为男性(84.7%),吸烟史、冠心病家族史阳性及心理压力较大者比例、甘油三酯水平显著高于老年组,而高血压、糖尿病史在老年患者更为多见,差异均有统计学意义(P<0.05);非老年组冠脉病变以单支为主(56.1%vs 13.7%,P<0.05)、症状典型、并发症少、预后好,老年组冠脉病变以三支多见(53.4%vs 15.9%,P<0.05)、症状不典型、并发症多、病死率高(13.3%vs 4.0%,P<0.05)。结论老年与非老年AMI患者的危险因素及临床特点不同,应有针对性地进行危险因素干预及治疗。

Risk factors and clinical features of acute myocardial infarction in elderly and non-elderly patients

Objective To explore the difference of risk factors and clinical features of acute myocardial infarction(AMI) between elderly and non-elderly patients.Methods A total of 312 AMI inpatients were divided into 2 groups:non-elderly group(<60 years,n=124)and elderly group(≥60 years,n=188).The risk factors,clinical features,complications and angiographic data were compared.Results Non-elderly patients were predominantly male(84.7%).Smoking,family history of coronary heart disease and higher psychological pressure were more frequent in non-elderly group than in elderly group.Non-elderly group had higher triglyceride(TG) level.Hypertension and diabetes mellitus were more prevalent in elderly patients(P<0.05).Non-elderly patients were more likely to have single-vessel disease(56.1% vs 13.7%,P<0.05),atypical clinical symptoms,less complications and better prognosis.Elderly patients had a higher prevalence of three-vessel disease(53.4% vs 15.9%,P<0.05),atypical clinical symptoms,more complications and higher mortality rate(13.3% vs 4.0%,P<0.05).Conclusion The risk factors and clinical features are different between elderly and non-elderly patients with AMI.Valid intervention measures for risk factors and therapy should be taken.