中青年和老年冠心病的临床特点及危险因素比较分析.pdf

中青年和老年冠心病的临床特点及危险因素比较分析

【摘要】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。

【Abstract】ObjectiveToinvestigatetheclinicalcharacteristicsandriskfactors

ofmiddle-agedandyoung,elderlypatientswithcoronaryarterydisease.Methods228

caseswithcoronaryarterydiseaseweredividedintomiddle-agedandyounggroup(46

cases,≤50years)andelderlygroup(182cases,≥60years).Thediseasehistory,fasting

bloodglucose,bloodfat,initialsymptom,extentofcoronaryartery

disease,complicationandriskfactorsoftwogroupswerecompared.ResultsThe

patientsofmale,smoking,drinking,hyperlipemia,familyhistoryandwithtypical

sternalgiasymptominmiddle-agedandyounggroupweremorecomparedwitelderly

group(allP＜0.01);theamountofpatientswithhypertensionanddiabetesin

middle-agedandyounggroupwaslesssignificantlycomparedwithelderlygroup(P＜

0.01);moresingle-vessellesionwasfoundinmiddle-agedandyoungpatientsthan

thatinelderlygroup,whilemultiplevessellesionwasjustthereverse;the

complicationsweremoreinelderlygroup.ConclusionWithtypicalsymptom,obvious

causativefactor,lesscomplicationandsingle-vessellesionareclinicalcharacteristics

ofmiddle-agedandyoungpatients,whileclinicalcharacteristicsofedlerlypatientsare

reversed.Male,smoking,drinking,hyperlipemia,familyhistoryofcoronaryartery

diseasearemainriskfactorsofmiddle-agedandyoungpatients,hypertensionand

diabetesareriskfactorsofelderlypatien