不同年龄组急性心肌梗死患者的临床和冠状动脉病变特征

The clinical and coronary arterial lesion's character in different age patients with acute myocardial infarction

目的 研究不同年龄组急性心肌梗死 (AMI)患者的临床特征与冠状动脉病变特点。方法 系统回顾性分析 32 5例不同年龄 (分为青年组、壮年组、老年组 ) AMI患者的临床特征及冠状动脉造影、冠状动脉介入治疗资料。结果 青年组发病均是男性 ,发病与吸烟、血脂异常危险因素有关 ;冠状动脉以单支、A型病变多见 ,冠状动脉介入治疗成功率为 90 .9%。壮年组发病男性多于女性 ,男性发病与血脂异常、吸烟、高血压等危险因素有关 ;冠状动脉以单、双支病变多见 ,病变形态 A、B、C三种类型均衡出现 ,冠状动脉介入治疗成功率为 95 .6 %。老年组女性发病率明显增高 ,男女发病与血脂异常、高血压、糖尿病、吸烟等危险因素有关 ,并发泵衰竭、严重心律失常及心源性休克增多 ;冠状动脉以多支、复杂病变多见 ,冠状动脉介入治疗成功率为 83.9%。结论 各年龄组男性和老年组女性患者发病率高并与某些危险因素有关 ;随年龄的增高 ,冠状动脉多支、复杂病变多见 ,青、壮年组冠状动脉介入治疗成功率高 ,老年组次之。

Object To observe the clinical and coronary arterial lesion's characteristics in different age patients with acute myocardial infarction (AMI). Methods The clinical materials and the data of coronary angiography and interventional treatment in 325 patients with AMI who were divided into three groups (young, middle age and elderly) were analyzed retrospectively. Results The clinical character is different among three groups. In young group, the risk factors are related to smoking and hyperlipidemia. And in middle age group, there are more factors except smoking and hyperlipidemia, such as hypertention, high plasma fibrinogen level. While in elderly group, Diabetes is the most important risk factor. Those patients in this group have serious complications, such as heart failure, severe arrythmia, and cardiac shock. On the other hand , the character of the coronary artery lesion is different, either. In young group, there are more simple and discrete lesion, while in elderly group, the complex and diffuse lesion were seen more often. Conclusion With growing old, the morbidity of AMI is increased, there are more risk factors, and the coronary lesion become more complex and diffuse. So the risk of death is higher, the success rate of intervention treatment is lower. We should use different method to deal with different age patient.