不同年龄段早发冠心病患者临床特征及危险因素的分析

Clinical characteristics and risk factors analysis of premature coronary heart disease patients in different age groups

目的:探究不同年龄段早发冠心病患者的临床特征以及危险因素。方法:选择2021年6月至2022年8月,在北京安贞医院门诊诊断为早发冠心病的380例患者作为研究对象,40岁<患者年龄≤59岁为中青年组,中青年组150例,59岁<患者年龄≤65岁为老年组,老年组230例。对两组患者的临床资料、实验室检查指标、冠心病的影响因素、冠状动脉病变情况及介入治疗后安全性,进行单因素分析,对单因素分析差异有统计学意义的因素带入多元线性回归,分析相关影响因素。结果:两组患者一般资料对比,仅性别差异有统计学意义(P<0.05)。与中青年组相比,老年组患者的Cr、血浆凝血酶原时间(prothrombin time,PT)、FIB水平明显高,但老年组的谷氨酸转肽酶、TG、Hcy以及PLT都明显低于中青年组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,Hcy、FIB进入回归模型;老年组3支病变者发生率均比较高(P<0.05),冠状动脉造影术后总的不良事件发生率更多(P<0.05)。结论:不同年龄段早发冠心病患者在临床实验室指标及预后方面存在差异。

Objective:To investigate the clinical characteristics as well as risk factors of patients with premature coronary heart disease in different age groups.Methods:A total of 380 patients diagnosed with premature coronary artery disease in outpatient clinics of our hospital from June 2021 to August 2022 were selected as the study subjects,40<patients'age≤59 for the middle-aged and young group,a total of 150 cases in the middle-aged and young group,59<patients'age≤65 for the elderly group,a total of 230 cases in the elderly group.The clinical data,laboratory test indexes,influencing factors of coronary heart disease,coronary artery lesions and safety after interventional therapy of the two groups were analyzed by one-way analysis.Factors with statistically significant differences in single-factor analysis were brought into multiple linear regression to analyze the relevant influencing factors.Results:Comparing the general information of patients in the elderly group and the young and middle-aged group,only gender was statistically significant(P<0.05).Compared with patients in the young and middle-aged group,patients in the elderly group had significantly higher levels of creatinine(Cr),plasma prothrombin time(PT),and fibrinogen(FIB),but glutamyl transpeptidase(GGT),TG,Hcy,and platelet counts(PLT)were significantly lower than those of the young and middle-aged group in the elderly group,with a statistically significant difference(P<0.05)The differences were statistically significant(P<0.05).As a result of multifactorial Logistic regression analysis,Hcy and FIB entered the regression model;compared with patients in the young and middle-aged group,the elderly group had a higher incidence of all three lesions(P<0.05).Compared with patients in the young and middle-aged group,the elderly group had a greater incidence of total adverse events after coronary angiography(P<0.05).Conclusions:Differences in clinical laboratory parameters and clinical prognosis of patients with early-onset coronary artery disease in different age groups suggest that there should be some differences in therapeutic regimens in the clinical treatment of coronary artery disease.