心肌梗死患者危险因素探讨

目的：探讨青、老年急性心肌梗死患者危险因素特点及不同独立相关危险因素。方法：入选120例住院急性心肌梗死患者,老年组88例（≥60岁,男/女,55/33）和青年组32例（〈45岁,男/女,31/1）,比较组间冠状动脉病变程度及相关危险因素。调查患者心血管疾病易患危险因素及有关生化检查,检测ABI、颈总动脉IMT,并行选择性冠状动脉造影。所有数据用SPSS13.0处理。结果：老年组女性、高血压、糖尿病比例明显高于青年组,TG、Gensini总积分、冠脉病变程度、颈总动脉IMT水平明显高于青年组;而青年组男性、吸烟、早发冠心病家族史比例明显高于老年组,ABI、CRP水平高于老年组。多因素分析发现,踝臂指数、颈总动脉IMT是老年组冠脉病变程度的独立相关危险因素,颈总动脉IMT是青年心肌梗死组冠脉病变程度的独立相关危险因素。结论：高血压、糖尿病、TG异常、ABI、颈总动脉IMT为老年心肌梗死突出危险因素;而踝臂指数、颈总动脉IMT为冠脉病变程度独立相关危险因素。男性、吸烟、早发冠心病家族史、CRP水平为青年心肌梗死突出危险因素;而颈总动脉IMT为冠脉病变程度独立相关危险因素。

Risk factors analysis of young adult and gerontal patients with acute myocardial infarction

Objective：To investigate the distinction of the risk factors between young adult and gerontal patients with acute myocardial infarction（AMI）.Methods：120 patients with AMI were collected,analyzed and compared.They were separated two groups according to age,32 young adult patients（below 45 years old,31 males and 1 female） and 88 gerontal patients（over 60 years old,55 males and 33 females）.All patients were investigated and their angiocardiopathy risk factors were recorded.They were detected the plasma of TC,TG,HDL-C,LDL-C,FBG,UA,CRP.Ankle/brachial index（ABI） and common carotid artery intima-media thick ness（IMT） were measured.Slecetive coronary arteriography were carried in all patients.All kinds of data were analyzed by SPSS 13.0.Results：The rates of female,hypertension,diabetes mellitus and the level of TG,Gensini＇s score,severity of coronary artery,common carotid artery IMT in gerontal patients were significantly higher than those in young adult patients.The rates of male,smoking,early onset cadiovascular diseases family history and the level of ABI,CRP in young adult patients were significantly higher than those in gerontal patients.Multivariate linear stepwise regression analysis showed that ABI,common carotid artery IMT were independent risk factors for severity of coronary artery in gerontal patients with AMI and common carotid artery IMT was independent risk factors for severity of coronary artery in young adult patients with AMI.Conclusion：Hypertension,DM,TG,ABI,common carotid artery IMT are significant risk factors in gerontal patients with AMI.ABI and common carotid artery IMT are independent risk factors for severity of coronary artery in gerontal patients with AMI.Male,smoking,early onset cadiovascular diseases family history and CRP are significantin risk factors in young adult AMI patients.Common carotid artery IMT is independent risk factors for severity of coronary artery in young adult patients with AMI.