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目的探讨总结不同年龄ST段抬高型心肌梗死患者冠状动脉造影特点,并对其临床特点进行分析。方法 2012年10月-2015年12月焦作市焦煤集团中央医院收治的急性心肌梗死患者568例,入院急查心电图均显示ST段抬高。搜集其完整临床资料并进行回顾性分析。依据患者年龄将患者分为18~40岁组、41~60岁组和>60岁组,对3组患者住院期间冠状动脉造影结果进行总结,并对患者临床特点及预后进行分析。结果 18~40岁组患者冠状动脉造影未见异常和单支病变者多见,罪犯血管以前降支最多见,后壁心肌梗死病变较低,与41~60岁组和>60岁组差异有统计学意义(P<0.05)。>60岁组患者住院期间死亡病例、心肌再梗死的发生率显著高于18~40岁组和41~60岁组差异有统计学意义(P<0.05)。>60岁组患者高血压、室性心律失常以及心功能IV级(Killip分级)所占比例高于18~40岁组差异有统计学意义(P<0.05),而18~40岁组冠心病家族史、吸烟、心功能Ⅰ级比例、血小板和甘油三酯水平高于>60岁组差异有统计学意义(P<0.05)。结论不同年龄急性心肌梗死患者冠状动脉造影特点存在差异,年龄较大者临床预后较差,应根据患者不同年龄给予针对性处理。
Objective To investigate the characteristics of coronary angiography in patients with ST-segment elevation myocardial infarction at different ages and analyze the clinical features. Methods From October 2012 to December 2015, 568 acute myocardial infarction patients admitted to Central Hospital of Jiaozuo Coking Coal Group were enrolled. Emergency electrocardiogram showed ST-segment elevation. Collect the complete clinical data and conduct a retrospective analysis. The patients were divided into 18 ~ 40 years old group, 41 ~ 60 years old group and> 60 years old group according to patient’s age. The results of coronary angiography during hospitalization were summarized and the clinical features and prognosis of the patients were analyzed. Results There was no abnormal coronary artery angiography and single vessel lesion in 18 ~ 40 years old group, the most serious anterior descending artery was in criminals, and the lesion in posterior wall myocardial infarction was lower. There was a significant difference between 41 ~ 60 years old group and> 60 years old group Statistical significance (P <0.05). The incidence of deaths and myocardial infarction in hospitalized patients> 60 years old was significantly higher than that of 18 ~ 40 years old group and 41 ~ 60 years old group (P <0.05). Patients in the 60-year-old group had higher rates of hypertension, ventricular arrhythmia and Killip classification than those in the 18-40-year-old group (P <0.05), while coronary heart disease Family history, smoking, first-class heart function ratio, platelet and triglyceride levels were higher than> 60 years old, the difference was statistically significant (P <0.05). Conclusion The characteristics of coronary angiography in patients with acute myocardial infarction at different ages are different. The older patients have poor clinical prognosis, and should be treated according to the patients’ different ages.