老年与青年急性心肌梗死患者相关因素的分析.docVIP

老年与青年急性心肌梗死患者相关因素的分析 　　[摘 要] 目的 探讨急性心肌梗死（AMI）45岁以下患者和60岁以 　　上患者的危险因素和临床特点? 　　方法 将确诊为AMI60岁的171例患者（老 　　年组）进行对照研究，分析其危险因素?冠状动脉病变和30天不良事件率等特点? 　　结果 青年组男性比例?吸烟者和高脂血症者较老年组多，而青年组糖尿 　　病?高血压和慢性肾功能不全低于老年组，差异均有统计学意义（P0.01）?老年组发 　　生30天不良事件高于青年组（P0.05） 　　?老年组和青年组30天不良事件发生组Killip分级≥3级和多支病变者更多，而LVEF值则更 　　低?老年组中，30天不良事件发生组糖尿病者比例?高脂血症者比例?CKMB高峰值水平皆 　　高于未发生组? 　　结论 吸烟?高脂血症和性别为青年AMI的主要危险因素，而老年AMI则较 　　多合并高血压?糖尿病和慢性肾功能不全?killip分级?冠状动脉病变的严重程度和左心室 　　收缩功能仍为影响预后的重要因素? 　　[关键词] 心肌梗死；老年；青年；相关因素 　　中图分类号：R542.2+2 　　文献标识码：A 文章编号：1009_816X 　　（2014）01_0016_03 　　doi：10.3969/j.issn.1009_816x.2014.01.07 　　Analysis on Related Factors among Young and Elderly Patients with Acute Myocardi 　　al Infarction. 　　CAI Xiao_jie， JIANG Long_fu. The Second Hospital of Ningbo City， Zhejiang 3150 　　10， China 　　[Abstract] Objective To explore the risk factors and clinical 　　features of acute myocardial infarction （AMI） among young and elderly patients. 　　Methods 　　A case_control study was conducted involving 68 young patients （45） an 　　d 171 elderly patients （60） with clinical diagnosis of AMI. The differences of 　　risk factors， clinical characteristics were analyzed between the two groups. 　　Results 　　Compared with the group with elderly patients， the risk factors of smoking and h 　　ypercholestero 　　lemia were more frequently found among the young patients（P0.01）， but the 　　rates 　　of hypertension? diabetes and chronic kidney disease were lower（P0.01） 　　. AMl pa 　　tients of male were more for youth than for elderly （P0.01） .The 30_day m 　　ajor a 　　dverse clinical outcome （MACO） was significantly lower in the young patients tha 　　n in the elderly patients （P0.05）. Either young or elderly AMI patients， 　　the 　　incidence of an advanced Killip score （defined as ≥ score 3 upon presentation） 　　and multiple vessel disease were significantly higher in group with 30_day MACO 　　than in group without 30_day MACO， whereas left ventricular ejection fraction（LV 　　EF） were significant