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目的:讨论不同年龄层心肌梗死患者冠状动脉病变特点,探索青年急性心肌梗死的发病机制。方法:收录本院自2007年-2009年收治的急性心肌梗死患者564例,分为青年组(年龄≤45岁)86例、中年组(年龄>45岁且≤65岁)255例、老年组(年龄>65岁)223例,这些患者均经PCI术治疗。通过病例对照关联分析进行统计。结果:青年组、中年组、老年组平均年龄分别为41±6.3岁、61±7.6岁、71±5.5岁;冠造结果显示,青年组患者以单支病变为主,犯罪血管以前降支病变占主要部分,与中年组、老年组相比,均具有显著差异;临床资料方面,与中年组、老年组相比,青年组在高血压、糖尿病等病史方面患病率更低。结论:中、老年患者以多支病变为主,多为长期病变急性加重,青年心肌梗死患者冠脉受累主要累及前降支,病变相对单一,可能与血管所受剪切力较大有关,同时提示遗传因素在其中的作用。
Objective: To discuss the characteristics of coronary lesions in patients with myocardial infarction of different ages and to explore the pathogenesis of acute myocardial infarction in young people. Methods: A total of 564 acute myocardial infarction patients admitted from 2007 to 2009 in our hospital were divided into 86 cases in young group (≤45 years old), 255 cases in middle-aged group (45 years old and ≤65 years old) Group (age> 65 years) 223 cases, these patients were treated by PCI. Statistical analysis by case-control analysis. Results: The average age of youth group, middle age group and old age group were 41 ± 6.3 years old, 61 ± 7.6 years old and 71 ± 5.5 years old, respectively. The results of coronal angiography showed that young patients were mainly single vessel disease, Compared with the middle-aged group and the elderly group, there were significant differences in the pathological changes. Compared with the middle-aged group and the elderly group, the youth group had a lower prevalence of hypertension, diabetes and other medical history. CONCLUSIONS: Middle-aged and elderly patients are mainly multi-vessel disease, mostly acute exacerbation of long-term disease. Coronary artery involvement in young patients with myocardial infarction mainly involves the anterior descending artery. The lesions are relatively single, which may be related to the greater shear stress on blood vessels. Prompt genetic factors in which the role.