青老年心肌梗死患者相关危险因素分析

Risk Factors Analysis on Young Adult and Gerontal Patients with Acute Myocardial Infarction

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 120例住院急性心肌梗死患者入选,老年组88例（≥60岁,男/女,55/33）和青年组32例（〈45岁,男/女,32/1）,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指标,检测踝肱指数（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 ①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.②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 ①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.②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.

Objective To investigate the distinction of the risk factors in young adult and gerontal patients with acute myocardial infarction（AMI）. Methods One hundred and twenty patients with AMI were collected in this study. They were divided into two groups according to age,young adult group（ n = 32 ,below 45 years old ,31 males and 1 female） and the aged group （ n = 88 ,over 60 years old ,55males and 33 females ）. All patients were investigated and their risk factors of angiocardiopathy were recorded. The plasma of TC, TG, HDL-C, LDL- C, FBG, UA and CRP were detected. Ankle/brachial index （ ABI ） and intima-media thick ness （ IMT ） of common carotid artery were measured. Selective coronary arteriography was carried on in all patients. All kinds of data were analyzed by SPSS13.0. Results （1）The rate 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 rate of male, smoking, early onset cadiovascular diseases family history and the level of ABI and CRP in young adult patients were significantly higher than those in gerontal patients. （2）Multivariate linear stepwise regression analysis showed that ABI, common carotid artery IMT were independent risk factors for severity of coronary artery in gerontal patients ,while AMI and common carotid artery IMT were independent risk factors for severity of coronary artery in young adult patients with AMI. Conclusion （1）Hypertension, DM, TG, ABI, common carotid artery IMT were significant risk factors in gerontal patients with AMI. ABI and common carotid artery IMT were independent risk factors for severity of coronary artery in gerontal patients with AMI. （2）Male,smoking, early onset cadiovascular diseases family history and CRP were significant in risk factors in young adult AMI patients. Common carotid artery IMT was independent risk factors for severity of coronary artery in young adult patients with AMI.