中青年冠心病患者危险因素及经皮冠状动脉介入治疗的临床分析

目的：探讨≤55岁中青年冠心病患者危险因素及经皮冠脉介入治疗（PC I）特点。方法：根据患者年龄分为中青年组（≤55岁,152例）和老年组（≥75岁,109例）,比较2组间发病的危险因素、PC I治疗特点及术后严重并发症情况,评价2组间PC I治疗疗效。结果：中青年组冠心病患者中男性、有阳性家族史、吸烟、高脂血症者明显多于老年组（P〈0.01）,老年组冠心病患者原发性高血压、糖尿病检出率高于中青年组（P〈0.01）。冠脉造影结果显示：中青年组患者以单支病变为主,且多为局限性狭窄,明显多于老年组（P〈0.01）;老年组患者三支血管病变、弥漫性狭窄病变、钙化病变明显多于中青年组（P〈0.01）;双支血管病变2组间无统计学意义。2组间支架置入情况相比,中青年患者右冠状动脉支架置入数少于老年组（P〈0.05）,差异有统计学意义。2组患者手术成功率及严重并发症（P〉0.05）差异无统计学意义。结论：吸烟、高脂血症、冠心病家族史是中青年冠心病发病的重要危险因素。中青年冠心病患者冠状动脉以单支血管病变居多,三支血管病变少见,弥漫性狭窄、钙化病变亦少见。中青年组冠心病患者右冠状动脉支架置入数少于老年组。

Clinical analysis of risk factors and percutaneous coronary intervention therapy of young-middle-aged patients with coronary artery disease

Objective:To analyse the risk factors and characteristics of percutaneous coronary intervention(PCI) therapy of young-middle-aged patients with coronary artery disease(CAD).Methods:The risk factors,characteristics of PCI and severe complication of 152 young-middle-aged CAD patients(≤55 y) and 109 old aged CAD patients(≥75 y) were collected,analysed and compared.Results:The rates of male,family history,smoking and hyperlipemia were significantly higher in young-middle-aged CAD patients than those in old-aged(P<0.01),and the rates of hypertension and diabetes mellitus were significantly lower(P<0.01).Coronary angiography illustrated that single-vessle lesions more occured in young-middle-aged group than old-aged group;Three-vessle,diffuse and calcifeid lesions occured more in old-aged group.There were no significant difference in two-vessle lesions between two groups.Stents embedded in right coronary artery were significantly less in young-middle-aged group than those in old-aged group(P<0.01).There were no significant difference in rate of success and severe complication between two groups.Conclusions:smoking,hyperlipemia and family history are important risk factors in young-middle-aged patients with CAD.Single-vessle lesions occured more in young-middle-aged group,but three-vessle,diffuse and calcifeid lesions occured less.Stents embedded in right coronary artery were significantly less in young-middle-aged group than those in old-aged group.