中青年与老年急性心肌梗死患者临床及冠状动脉造影分析

目的分析和比较中青年与老年急性心肌梗死（AM I）患者的危险因素,发病诱因、临床特点及冠脉病变特点。方法系统回顾分析260例AM I患者,按年龄分为中青年组（〈60岁）和老年组（≥60岁）2组,比较2组临床特征及冠脉造影的特点。结果2组中男性发病比例明显高于女性,女性发病比例在老年组明显高于中青年组。其中中青年组主要危险因素以吸烟、血脂异常为多见。起病时多有急性典型胸痛。冠脉病变以单支病变多见。老年组主要危险因素以高血压和血脂异常为多见。起病症状不典型者多见。冠脉造影提示三支病变发生率明显高于中青年组。结论中青年和老年患者中导致AM I的危险因素不尽相同,且临床表现及冠脉病变特征也不同。临床工作中应加以区别对待。

Analysis on the differences of clinical symptoms and lesion of coronary arteries between adults and oldsters with acute myocardial infarction

Objective To analyze risk factors,predisposing inducements,clinical symptoms,lesion of coronary arteries in different age groups with acute myocardial infarction（AMI）.Methods The cases were divided into 2 groups： adult group（younger than 60 years） and oldster group（older than 60 years）.Investigation was conducted as to the differences of clinical characters and lesion of coronary arteries through coronary arteriography between the adult group and the oldster group.Results The incidence of AMI in the oldster group is obviously higher than in the adult group.In the adult group,smoking and disorder of lipids are the most important risk factors.The patients usually have typical symptoms with single branch of coronary arteries damaged.In the oldster group,hypertension and disorder of lipids are the most important risk factors.The patients normally have no typical clinical symptoms with more than one branch of coronary arteries damaged.Conclusion Different age groups have different high risk factors,clinical symptoms and different number of damaged branches.