高龄急性心肌梗死患者冠状动脉造影特点的分析

Risk factors and coronary angiographic findings in elderly and non-elderly patients with acute myocardial infarction:a comparative analysis

目的:探讨高龄和非高龄急性心肌梗死(AMI)患者的危险因素及冠状动脉造影特点。方法:将临床确诊为AMI年龄≥75岁的58例患者(高龄组)与<75岁的87例患者(非高龄组)进行对照研究,分析其危险因素和冠状动脉造影特点。结果:高龄组的AMI危险因素中合并高血压的比例明显高于非高龄组,而吸烟史和AMI阳性家族史比非高龄组明显低。血脂谱分析显示高龄组包括总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和载脂蛋白B(ApoB)显著低于非高龄组。冠状动脉造影(CAG)显示高龄组多支病变居多(94.8%),显著多于非高龄组(72.4%),单支病变(5.2%)明显少于非高龄组(27.6%)。冠状动脉病变程度用Gensini积分比较,高龄组(86.32±44.91)显著高于非高龄组(58.93±27.95)。结论:高龄AMI患者最常见的危险因素是高血压病,特点是冠状动脉多支病变常见,冠状动脉病变狭窄程度显著高于非高龄组。

Objective：To compare the risk factors and coronary angiographic（CAG） findings in elderly and non-elderly cases.Methods：The risk factors and characteristics of CAG findings were analyzed between 58 cases elderly（75 years and older） and 87 non-elderly（below 75 years old） patients with AMI.Results： Compared with the non-elderly patients,the rates of hypertention were higher in the elderly,but the risk factors of smoking and positive family history were less.The total cholesterol（TC）,triglyceride（TG）,low-density lipoprotein cholesterol（LDL-C） and apolipoprotein B（ApoB） were significantly lower in the elderly patients.There were more multi-vessel diseases in the elderly patients（94.8% vs 72.4%）.Gensini score of coronary angiography was higher in the elderly patients（86.32±44.91 vs 58.93±27.95）.Conclusion： Hypertension was the major risk factors of AMI in individuals above the age of 75,who have more coronary multi-vessel diseases and severe stenosis than non-elderly patients