不同年龄段冠心病患者临床及冠状动脉病变特点

目的探讨不同年龄段冠心病(CHD)患者的临床及冠状动脉病变特点。方法275例CHD患者根据年龄分为青年组(<45岁)17例,中年组(45~60岁)83例,普通老年组(60~75岁)138例和高龄老年组(≥75岁)37例,对4组患者的临床特点、血生化指标及冠状动脉造影(CAG)结果进行比较分析。结果4组比较,随年龄增长吸烟比例逐渐降低(P<0.05),而高血压患病率逐渐升高(P<0.01);随年龄增长血尿酸水平逐渐升高(P<0.01)。CAG结果比较,青年组和中年组以单支病变为主,而普通老年组和高龄老年组以多支病变较多;普通老年组和高龄老年组左回旋支(LCX)和右冠状动脉(RCA)病变所占比例均明显多于青年组和中年组(P<0.05,P<0.01);普通老年组和高龄老年组ACC/AHA(美国心脏病学会和美国心脏病协会)积分和弥漫长病变所占比例明显高于中年组(P<0.01)。结论不同年龄段冠心病患者有不同的临床和冠状动脉病变特点,不同年龄人群应采取有针对性的冠心病防治措施;不同年龄人群冠脉病变血管部位不同,普通老年人和高龄老年人LCX和RCA病变所占比例较大。

Clinical and damaged coronary arterial characteristics of different aged patients with coronary heart disease

Objective To explore clinical and damaged coronary arterial characteristics of different aged patients with coronary heart disease(CHD).Methods Two hundred and seventy-five patients with CHD were divided into four groups according to age:young group(<45 years old),middle-age group(45-60 years old),elderly group(60-75 years old) and high-elderly group(≥75 years old).The clinical characteristics,biochemical indicator and result of coronary arteriongraphy(CAG) in four groups were compared.Results With age increasing,there were more hypertension patients and less smoking patients(P<0.05,P<0.01),uric acid levels were more and more high(P<0.01).More single-vessel lesion was found in young and middle-age patients than that in elderly group and high-elderly group,while multiple vessel disease was just the reverse.left circumflex coronary artery and right coronary artery vessel disease occurred more frequently in the elderly patients than in young and middle-age patients(P<0.05,P<0.01).Compared with those of middle-age group,ACC/AHA scores and the rates of diffuse lesions of elderly group and high-elderly group were also higher(P<0.01).Conclusion Effective different prevent measures should be adopted in different aged patients with different clinical and damaged coronary arterial characteristics.The place of damaged artery is unlike in different ages patients.LCX and RCA diseases in the elderly patients occur more frequently than in young and middle-age patients.