不同性别和年龄急性心肌梗死患者的相关危险因素及冠状动脉病变特点

目的分析不同性别和年龄的急性心肌梗死（AMI）患者的危险因素及冠状动脉病变的特点，为针对性预防提供理论依据。 方法选取2017年1~10月青岛大学附属医院收治的AMI患者1050例，男性683例，女性367例，<50岁患者124例、50~59岁患者199例、60~69岁患者330例、≥70岁患者397例。分析不同年龄和性别患者的危险因素和冠状动脉病变特点。 结果男性AMI患者平均发病年龄低于女性［（62.01±12.35）岁 vs （71.43±9.75）岁，P<0.01］；随年龄增长，吸烟患者的比例和患者的体质量指数均呈下降趋势，而女性患者的比例逐渐增加；患者合并高血压病的比例随年龄增加呈先升后降的趋势，比例最高的是60~69岁年龄组（62.4%），男性患者合并高血压病的比例高于女性（54.9% vs 46.1%，P<0.05）；合并糖尿病的比例随年龄增加而升高，60岁以后各年龄段女性合并糖尿病的比例均较男性偏高（40.0% vs 27.3%，42.6% vs 26.4%，P均<0.05），尤其ST段抬高型心肌梗死患者中，女性合并糖尿病的比例在50~59岁组最高达55.6%；随年龄的增长，患者血清三酰甘油水平逐渐降低，高密度脂蛋白胆固醇逐渐升高；冠状动脉造影结果显示，AMI患者病变血管支数随年龄的增长而增加，<50岁的患者单支血管病变比例高达50.9%，<50岁的患者以左前降支病变最为常见，> 70岁的患者以左前降支、右冠状动脉病变多见。 结论针对不同性别和年龄的AMI患者可采取差异化的防治措施。

Risk factors and characteristics of coronary lesions in patients with acute myocardial infarction of different gender andage

ObjectiveTo analyze the regional characteristics of risk factors and coronary artery lesions in patients with acute myocardial infarction (AMI) of different genders and age groups in Qingdao, where there is a high incidence of coronary heart disease. MethodsFrom January to October 2017, 1050 AMI patients admitted to the Affiliated Hospital of Qingdao University were divided into male (n=683) and female (n=367) groups,<50 years old (n=124 cases), 50-59 years old (n=199 cases), 60-69 years old (n=330 cases), and≥70 years old (n=397 cases) group according to gender and age. The risk factors and characteristics as well as coronary lesions were analyzed. ResultsThe average age of onset of male AMI patients was significantly lower than that of females [(62.01±12.35) years old vs (71.43±9.75) years old, P<0.01). With the increase of age, the proportion of smoking patients and the body mass index (BMI) of patients showed a downward trend, while the proportion of female patients gradually increased. The proportion of patients with hypertension increased first and then decreased with age, with the highest proportion observed in the 60-69 age group (62.4%). The proportion of male patients with hypertension was higher than that of females (54.9% vs 46.1%, P<0.05). The proportion of patients with diabetes increased with age, and after the age of 60, the proportion of women with diabetes in all ages is higher than that of men (40.0% vs 27.3%, 42.6% vs 26.4%, P<0.05 of all), especially in patients with ST-segment elevation myocardial infarction; the proportion of women with diabetes was up to 55.6% in the 50-59 age group. With the increase of age, triacylglycerol (TG) levels gradually decreased, and high-density lipoprotein (HDL-C) levels gradually increased. Coronary angiography results showed that the number of vascular lesions in patients with AMI increased with age. In patients aged<50 years, the single vessel lesion rate was as high as 50.9%; patients aged<50 years were most commonly diagnosed with LAD lesions; in patients aged>70 years, LAD and right coronary artery (RCA) lesions were more common. ConclusionDifferent prevention and treatment measures can be taben for AMI patients of different gender and age.