青年与老年患者急性心肌梗死的临床特点分析

Analysis of clinical features of acute myocardial infarction in young and older patients

目的分析青年与老年患者急性心肌梗死(AMI)的临床特点,为临床诊疗提供参考依据。方法选取104例住院的青年(年龄≤45岁)AMI患者(青年组),以同期住院的121例老年(年龄≥65岁)AMI患者作为对照,分析AMI危险因素、临床表现、冠脉病变特点及治疗策略。结果青年组吸烟、冠心病家族史、高脂血症、典型胸痛明显高于老年组(P<0.05),青年高血压、糖尿病的发病率、并发症以及病死率低于老年组(P<0.05)。青年组多系单支、中度血管病变为主,老年组以多支、重度血管病变为主。青年组药物保守治疗比例较老年组高(P<0.05),老年组患者采用冠状动脉旁路移植术治疗多于青年组(P<0.05);青年组患者从症状发作到医院时间、医院到导管室时间均小于老年组(P<0.05)。结论青年与老年AMI患者的相关危险因素、临床表现、冠脉病变特点及治疗策略存在差异。

Objective To analyze the risk factors, clinical characteristics and coronary artery lesion in the young and older patients with acute myocardial infarction. Methods A total of 104 patients with acute myocardial infarction （≤45 years old） were included in this study. Another 121 patients with acute myocardial infarction （≥65 years old） in hospital at the same period were as control. The cardiovas-cular risk factors, clinical characteristics, coronary angiography （ CAG） features and treatment strategy were analyzed. Results Compared to aged group, young group had a significantly higher rate of smoking, family history of coronary heart disease （P〈0. 05）, and hyperlipi-demia （ P〈0. 05 ） . The incidence rate of hypertension, diabetes, complications and mortality rate was lower than that of the aged group （P〈0. 05）. The clinical manifestations of young patients with typical chest pain had a significantly higher occurrence than of aged group;compared with the aged group, the young group had a significantly difference in single vessel lesion （P〈0. 05）. The incidence of severe le-sions was more frequent in old-group （P〈0. 05）, moreover, the old-group had a higher rate of coronary artery calcification （P〈0. 05）. The young group had higher ratio in drug therapy than old-group, but the later was higher in the CABG treatment than young-group. There was no significant difference in the in emergency or elective PCI. However, the young group had less time than the older age group at the time fromonset of symptoms to hospital and from the hospital to the catheter lab （P〈0. 05）. Conclusion There are differences in the risk factors, clinical manifestation, the characteristic of coronary artery disease and treatment strategies when the young patients are compared with the aged with acute myocardial infarction.