中青年和老年冠心病的临床特点及危险因素比较分析

目的探讨中青年和老年冠心病患者的临床特点及其危险因素。方法将冠心病患者228例，按年龄分为中青年组46例（≤50岁）和老年组182例（≥60岁）。所有患者均有完整的病历资料和冠状动脉造影结果，调查既往史，测定空腹血糖、血脂等生化指标，比较初发症状、冠状动脉病变支数、并发症及危险因素等方面的差异。结果中青年组男性、吸烟、饮酒、高血脂、家族史及具有典型心绞痛症状的患者均高于老年组（均P〈0．01）；高血压、糖尿病低于老年组（均P〈0．01）；冠状动脉病变中青年组以单支病变为主，而老年组以多支病变居多（P〈0．01）；并发症以老年组较多。结论中青年组冠心病患者具有症状典型且有明显诱发因素、并发症少、以单支冠脉病变为主的特点，老年组患者的临床特点是症状多样化和不典型、并发症及并存病多、易误诊和漏诊。男性、吸烟、饮酒、高血脂症、冠心病家族史是中青年患者的主要危险因素，高血压和糖尿病则是老年患者的危险因素。有效地干预危险因素，是冠心病防治的关键。

Clinical characteristics and risk factors analysis of middle-aged and young,elderly patients with coronary artery disease

Objective To investigate the clinical characteristics and risk factors of middle-aged and young, elderly patients with coronary artery disease. Methods 228 cases with coronary artery disease were divided into middle-aged and young group（46 cases,≤50 years） and elderly group（ 182 cases, ≥60 years）. The disease history, fasting blood glucose, blood fat, initial symptom, extent of coronary artery disease, complication and risk factors of two groups were compared. Results The patients of male, smoking, drinking, hyperlipemla, family history and with typical sternalgia symptom in middle-aged and young group were more compared wit elderly group （ all P 〈 0.01 ） ; the amount of patients with hypertension and diabetes in middle-aged and young group was less significantly compared with elderly group （ P 〈 0. 01 ） ; more single-vessel lesion was found in middleaged and young patients than that in elderly group, while multiple vessel lesion was just the reverse ; the complications were more in elderly group. Conclusion With typical symptom, obvious causative factor, less complication and single-vessel lesion are clinical characteristics of middle-aged and young patients, while clinical characteristics of edlerly patients are reversed. Male, smoking, drinking, hyperlipemia, family history of coronary artery disease are main risk factors of middle-aged and young patients, hypertension and diabetes are risk factors of elderly patients. Effective different prevent measures should be adopted in different aged patients with different clinical and damaged coronary arterial characteristics.