高龄老年急性心肌梗死患者临床特点分析

Clinical characteristics of acute myocardial infarction in elderly patients

目的 探讨高龄老年急性心肌梗死（AMI）患者的临床特点.方法 回顾性分析行直接经皮冠状动脉介入治疗（PCI）的58例高龄（＞75岁）AMI患者临床资料,并通过Gensini评分系统对患者冠状动脉病变程度进行评分.结果 高龄老年AMI患者中,合并高血压病患者最多,为40例（69.0％）,其次是合并高脂血症患者37例（63.8％）和合并糖尿病患者17例（29.3％）.在AMI合并高脂血症患者中,低高密度脂蛋白血症最常见,为23例（62.2％）.AMI患者发病时,有6例（10.3％）为非ST段抬高型,52例（89.7％）为ST段抬高型.所有患者均行直接PCI治疗,冠状动脉造影显示2支冠状动脉病变者30例（51.7％）；3支病变者次之,为25例（43.1％）；单支病变者最少,为3例（5.2％）.患者平均Gensini评分为（86 ±45）分.结论 高龄老年AMI患者常见危险因素是高血压病、高脂血症和糖尿病,冠状动脉造影示冠状动脉多支病变常见,病变程度重.

Objective To analyze the characteristics of clinical and coronary angiographic features in elderly patients with acute myocardial infarction（AMI）.Methods Fifty-eight patients aged≥75 years with acute myocardial infarction admitted to our hospital from 2006 to 2009 were analyzed retrospectively.Gensini score was used to evaluate the pathological change degree of coronary artery in the elderly patients with AMI.Results Hypertension,as the most common co-morbidity,accounted for 69.0% （40 cases） of all patients.Dyslipidemia was 63.8% （37 cases） and diabetes was 29.3 % （ 17 cases）.62.2% （23 cases） of patients with dyslipidemia had lower high density lipoprotein cholesterol（HDLC）.6 cases of myocardial infarction manifested with non ST-elevation myocardial infarction（NSTEMI）.52 cases（ 89.7% ） showed ST-elevation myocardial infarction（STEMI）.Regarding the number of vessels involved,double-vessel disease（ 30 cases,51.7% ） was the highest,the triple-vessel disease （25 cases,43.1% ） was in the middle and single-vessel disease （3 cases,5.2% ）was the lowest.The mean of Gensini score was 86.32 ±44.91.Conclusions Hypertension,hyperlipoidemia and diabetes are the common risk factors for coronary heart disease in the senile.The rate of multi-vessel disease is comparatively higher in patients aged more than 75 years with AMI and the pathological change degree of coronary artery is serious.