早发冠心病患者冠脉病变特征及介入术后预后随访分析

目的探讨早发冠心病（PCAD）患者冠状动脉病变特征及介入治疗后预后特点。方法选取经冠状动脉造影（CAG）确诊的冠心痛（CAD）患者共670例，根据年龄分为PCAD组319例和老年CAD组351例，对两组患者的相关资料进行回顾性统计分析，记录患者冠状动脉造影结果，分析PCAD患者的冠状动脉病变特点，对其血脂水平、高血压病史、糖尿病病史、CAD家族史、吸烟史等作相关分析，随访观察患者介入术后预后特点。结果PCAD组中吸烟史、CAD家族史病例数及血清总胆固醇水平高于老年CAD组而高血压病史、糖尿病史发病率低于老年CAD组。PCAD组冠状动脉病变多为单支病变，Gensini冠脉积分老年组明显高于PCAD组。术后随访情况，PCAD组行PCI术228例（71．5％），老年CAD对照组209例（59．5％），两组间PCI术后病死率和心血管事件发生率等预后情况有明显差异。总心血管事件发生率均是PCAD组低于老年CAD组。结论吸烟、CAD阳性家族史，高胆固醇血症均是PCAD的主要危险因素，其冠状动脉病变特点以单支病变为主，介入治疗术后预后相对优于老年CAD患者。

Objective To investigate the risk factors and clinical manifestation of coronary lesions in patients with premature coronary heart disease and the prognosis of these patients after PCI. Methods Coronary angiography was done in 670 coronary heart disease patients were divided into two groups by age, 319 patients with premature coronary heart disease were compared with 351 patients with gerontism coronary heart disease. The clinical features of coronary lesions and the prognosis after PCI was used to illustrate the risk factors in the patients of premature coronary heart disease. Results Smoking history, CAD family history, serum total cholesterol in PCAD group were higher than those in elderly CAD group, while the incidence of hypertension history and diabetes history were lower than that of elderly CAD group. The coronary artery lesions in group PCAD were mostly single vessel lesions, and the Gensini coronary score in elderly group was significantly higher than that in PCAD group. After the fonow-up, 228 cases （ 71.5% ） were treated with PCI, and 209 cases （ 59.5% ） in the elderly CAD control group. There were significant differences between the two groups in the mortality rate and the incidence of cardiovascular events after PCI surgery in the PCAD group. The incidence of cardiovascular events in group PCAD was lower than that in group CAD. Conclusion Smoking, family history of coronary heart disease, hypercholesterolemia are important risk factors for patients with premature coronary heart disease. Most of the patients with premature coronary heart disease are single-vessel lesions. Coronary heart disease prevention should begin with controlling the coronary heart disease risk factors.