青壮年男性急性心肌梗死患者冠状动脉造影特点分析.DOCVIP

临床医学论文-青壮年男性急性心肌梗死患者冠状动脉造影特点分析 ?????????? 作者：张爱华，刘梅林，朱正炎 【摘要】? 目的 探讨青壮年男性急性心肌梗死患者的冠状动脉造影特点。方法 比较青壮年组（103例）与老年组（238例）男性急性心肌梗死患者的冠状动脉造影特点及治疗方式。结果 青壮年组平均年龄（41.80±13.69）岁,老年组平均年龄（66.96±5.52）岁;单支病变为74.7% vs 32.8%，双支及三支病变为12.6% vs 31.5%，11.7% vs 35.7%，P0.001；侧支循环（0级﹑1级﹑2级﹑3级）为80.5% vs 49.6%﹑12.7% vs 26.05%﹑6.8% vs 18.05%﹑0 vs 6.3%，P＜0.05，有统计学意义；梗死相关血管：左前降支右冠状动脉﹑回旋支分别为，57.8% vs 63.0%、28.4% vs 30.7%、13.8% vs 6.3%，P=0.331，无统计学意义。青壮年组、老年组行“冠状动脉旁路移植术”治疗的比例为6.7% vs 37.8%，P＜0.05。结论 青壮年病人以单支偏心无钙化的局限型病变为主，侧支循环不明显；梗死相关血管无统计学差异，且病人预后好，行冠状动脉旁路移植术比率低。 【关键词】? 急性心肌梗死；冠状动脉造影 ??? Analysis on angiographic characteristics in young and middle-aged male patients with acute myocardial infarction ??? ［Abstract］? Objective? To study the angiographic characteristics in young adults with acute myocardial infarction.Methods? The angiographic characteristics and therapy in the young patients （103 patients,≤45 years old） with that in the old patients （238 patients,≥60years old） was compared.Results? The mean age in young patients was （41.80±13.69）years old,the mean age in the old patients was （66.96±5.52）years old.The proportion of single-branch disease was 74.7% vs 32.8%,the proportion of three-branch disease was 11.7% vs 35.7%（P＜0.001）;the collateral circulation （grade: 0,1,2,3 ）were 80.5% vs 49.6%（P＜0.001）.LAD was the most coronary artery disease in the young patients and in old patients （P=0.331）.The proportion of coronary artery bypass grafting （CABG） in the young patients and old patients were 6.7% vs 37.8%（P＜0.05）.Conclusion? This manifests single-vessel,centric calcify,limit disease is more often in young patients than in old patients,the prognosis is better in young patients.The therapy of CABG is lower. ??? ［Key words］? acute myocardial infarction;angiography ??? 2000年世界卫生组织报告，全球1700万人死于动脉粥样硬化，1/3为冠状动脉粥样硬化，80%在发展中国家。文献报道45岁以下患有心肌梗死的病人占所有心肌梗死病人的6％～10％，其中80％有冠状动脉粥样硬化。本文通过对青壮年和老年急性心肌梗死的比较，总结青壮年急性心肌梗死患者冠状动脉造影的特点。 ??? 1? 资料与方法 ??? 1.1? 一般资料? 全部病例来自我院2003年1月～2005年8月住院并接受经皮冠状动脉介入治疗（PCI）的男性急性心肌梗死患