老年与青年急性心肌梗死临床特点分析

A Clinical Analysis of the Characteristics of AMI in the Elderly and in the Young

目的 :探讨老年人与青年人急性心肌梗死的临床特点。方法 :分析老年人组及青年人组发病的危险因素及促发因素和冠状动脉造影的阳性指标 ,确诊为急性。结果 :冠心病危险因素 :吸烟 :老年组占 70 % ,青年组占 95 %。饮酒 :老年组占 76 % ,青年组占 90 %。血脂水平 :血清胆固醇 ,两组P >0 .0 1无显著性差异。血清甘油三脂 ,两组有显著性差异P <0 .0 1。促发因素 ;高血压病、糖尿病、心绞痛老年组患病率为 16例 (2 6、6 % ) ,青年组患病率为 2例(10 % )。冠状动脉粥样硬化情况 ;老年组以双支及多支狭窄为。青年组以单支狭窄为主。冠状动脉狭窄的程度 :老年组 86 .4 4 %± 11.13,青年组 6 5 .6 9%± 11.36 ,两组有显著性差异P <0 .0 1。并发症 :室壁瘤 :两组病例均以单支狭窄的发生率为高。心律失常 :老年组以复杂的心律失为主 ,青年组以单纯性心律失常为主。结论 :冠心病危险因素青年组明显高于老年组 ,老年组甘油三脂的水平、以及促发因素明显高于青年组。冠状动脉粥样硬化的情况 :老年组以双支及多支病变为主而青年组则以单支病变为主。冠状动脉狭窄的程度 :老年组以重度狭窄为主而青年组以中度狭窄为主。老年组并发症明显高于青年组 。

Objective: To evaluate characteristics of acute myocardial infarction AMI in the elderly and the young. Methods: Eighty patients, who were confirmed to be diagnosed AMI, were divided into two groups: old people (OP) group and young people (YP) group. Either of them had typical clinical features, electrocardiogram findings, variations of CK, GOT, LDH, etc., and coronary artery angiography(CAG)findings of AMI. Results: Coronary artery disease (CAD) risk factors: smoking: 70% in OP group and 95% in YP group; Alcoholic drinking: 76% in OP group and 90% in YP group; serum lipid level: there was no significant deference in cholesterol between the two groups ( P >0.01). But there was a significant difference in serum triglycerides between them. Stimulus factors: Morbidity rate of Essential Hypertension, Diabetes Millitus, angina pectoris: 16 cases (26.6%) in OP group and 2cases(10%) in YP group. The morbidity rate of patients with two and multiple coronary arteries atherosclerosis was high in OP group. The morbidity rate of patients with single coronary artery atherosclerosis was high in YP group. Extent of coronary artery lesions: 86.44%±11.36 in YP group. There was a significant difference between the two groups( P <0.01). Complications: Cardiac aneurysm: 17 cases (28%) in OP group and 2 cases (10%) in YP group. The morbidity rates of patients with a single vessel lesion were high in the two groups. Arrhythmia: 22 cases (37%) in the OP group, and 3 cases (15%) in the YP group.The arrhythmias were complicated in OP group and were simple in YP group.Conclusion: CAD risk factors: The number of smoking and alcoholic drinking patients in the YP group is more than those in the OP group, and the level of serum triglyceride group. Coronary artery atherosclerosis: the morbidity rate of two and multiple in the populations of stimulus factors of the OP group is higher than that of the YP group; morbidity rate of the coronary arteries atherosclerosis is high in the OP group and that of the single coronary artery atherosclerosis is high in the YP group. Extent of coronary artery lesions: it is more serious in the OP group than the YP group. The complications in the OP group are more than those in the YP group. And the seriousness of the complications in the OP group is more than that in the YP group.