不同年龄层次急性心肌梗死患者临床特点对比观察

Clinical characteristics in patients with acute myocardial infarction with different age levels

目的对比研究不同年龄层次急性心肌梗死(AMI)患者的临床特点及冠脉病变特点。方法序贯入选AMI患者226例,按年龄层次分为青年组、中老年组及高龄组。比较3组人群的临床特征及冠脉造影结果。结果两两比较3组患者高血压病比例、总胆固醇、低密度脂蛋白、甘油三酯、高密度脂蛋白组间差异均无统计学意义(P>0.05)。青年组中年组吸烟比例较中老年组、高龄组明显增高,与其比较差异有统计学意义(P<0.05)。3组患者发病至入院时间、入院至导管室时间随年龄增加,逐渐升高。高龄组糖尿病史、血肌酐、肌酸激酶、肌酸激酶同工酶MB、肌钙蛋白I与青年组、中老年组相比差异均具有统计学意义(P<0.05)。比较高龄组患者与青年组、中老年组患者Gensini评分差异均具有统计学意义(P<0.05)。青年组与中老年组患者Gensini评分之间差异无统计学意义(P>0.05)。结论急性心肌梗死在不同年龄层次患者中的临床特点及病变程度不尽相同,其发病机制可能略有不同。不同年龄层次急性心肌梗死的特点对于临床诊疗具有重要意义。

Objective The clinical characteristics of different age levels in patients with acute myocardial infarction and coro-nary artery lesion characteristics were studied comparatively. Methods 226 cases of AMI patients, according to the ages were selected sequentially and divided into young group, elderly group and aged groups. clinical characteristics of three groups of people and the re-sult of coronary angiography were compared. Results Pairwise comparison of three groups of patients with hypertension disease per-centage, total cholesterol, low-density lipoprotein cholesterol （ LDL-C） , triglycerides, high-density lipoprotein cholesterol （ HDL-C） were not statistically significant （P〉0.05）. Young, middle-aged smoking rate was significantly higher than elderly group and aged group, and the difference was statistically significant （ P〈0.05）; Three groups of patients with onset to admission time, admission to international time increased along with the age increasing. The differences of history of diabetes, serum creatinine, creatine kinase, creatine kinase isoenzyme MB, troponin I between elderly group and young group, were statistically significant （P〈0.05）. Gensini score between senile patients and young group, elderly group was significantly different （P〈0.05）. Gensini score between young pa-tients and elderly group was significantly different （ P〉0.05） . Conclusion The clinical characteristics and pathological changes degree are not the same in patients with acute myocardial infarction （ AMI） in different age groups, and its pathogenesis may be slightly differ-ent. Different age groups is of great significance for clinical diagnosis and treatment of acute myocardial infarction.