不同年龄段急性心肌梗死病人临床和冠状动脉病变特点分析

目的探讨不同年龄段急性心肌梗死（AMI）病人的临床和冠状动脉（冠脉）病变特点。方法选择201例行急诊冠脉造影检查的AMI病人，根据年龄分为中青年组（< 60岁，n=70）和老年组（≥60岁，n=131），比较2组病人的临床资料和冠脉病变资料。结果AMI老年病人较中青年病人更容易发生院内死亡和心力衰竭（P < 0.05）；中青年组病人的红细胞计数、血红蛋白、血细胞比容、网织红细胞计数、淋巴细胞计数、嗜酸性粒细胞计数、丙氨酸氨基转移酶、胆碱酯酶、总蛋白、白蛋白、尿酸、总胆固醇、低密度脂蛋白和载脂蛋白B水平均高于老年组（P < 0.05~P < 0.01），脂蛋白a低于老年组（P < 0.05）。中青年组病人冠脉以单支血管病变、低Gensini积分为主，术中发生无/慢复流的概率低；老年组病人冠脉以多支血管、钙化病变、高Gensini积分为主，术中容易出现无/慢复流，2组比较差异有统计学意义（P < 0.05~P < 0.01）。结论中青年AMI病人的血压、血糖、血脂水平更高，冠脉病变以单支、低Gesini积分病变为主。老年AMI病人冠脉病变以弥漫性长病变、钙化病变为主，术中容易发生无/慢复流。

Analysis of the clinical and coronary lesion characteristics in different age patients with acute myocardial infarction

ObjectiveTo investigate the clinical and coronary lesion characteristics in different age patients with acute myocardial infarction(AMI).MethodsTwo hundred and one AMI patients were detected using emergency coronary angiography, and divided into the young and middle-aged group(age < 60 years old, n=70) and elderly group(age ≥ 60 years old, n=131) according to their ages.The clinical data and coronary artery disease data were compared between two groups.ResultsElderly patients with AMI were more prone to have in-hospital death and heart failure compared with young and middle-aged patients(P < 0.05).The levels of red blood cell count, hemoglobin, hematocrit, reticulocyte count, lymphocyte count, eosinophil count, alanine aminotransferase, cholinesterase, total protein, albumin, uric acid, total cholesterol, low density lipoprotein and apolipoprotein B in young and middle-aged group were higher than those in elderly group(P < 0.05 to P < 0.01), and the level of lipoprotein a in young and middle-aged group was lower than that in elderly group(P < 0.05).In the young and middle-aged group, the single-vessel lesion and low Gensini score were the main performance, and the probability of no/slow reflow was low.In the elderly group, the coronary arteries were mainly composed of multiple vessels, calcification lesions and high Gensini score, and no/slow reflow was easy to occur during the operation.The difference of which between two groups was statistically significant(P < 0.05 to P < 0.01).ConclusionsThe levels of blood pressure, blood glucose and blood lipid in young and middle-aged patients are higher, and the coronary artery lesions are mainly single-branch and low Gesini score lesions.In the elderly patients, the coronary artery lesions are mainly diffused long lesions and calcificated lesions, and no/slow reflow is easy to occur during the operation.