摘要
目的比较青年与中老年急性ST段抬高型心肌梗死患者(STEMI)的临床特点及预后。方法回顾性分析2018年9月至2018年12月就诊于河北医科大学第二医院胸痛中心的STEMI并行经皮冠状动脉介入治疗(PCI)的患者187例,给予相同药物干预,同时根据年龄分为青年组25例(≤44岁),中老年组162例(>44岁)。比较两组患者入院时一般资料,相关实验室指标,心脏超声,冠状动脉(冠脉)造影,住院时长,出院后3月心脏超声,术后1年内主要不良事件(MACE)及出血事件的发生情况。结果青年组相较中老年组男性患病率高,收缩压相对低,糖化血红蛋白水平相对较低,白蛋白水平、白细胞计数、血小板计数相对较高,D-Dimer相对较低,肌钙蛋白相对较低,血UA水平相对较高,治疗后E/e'降低更多,病变血管支数相对较低,支架个数相对较少,住院天数较少,出现严重心力衰竭时间相对较少(P<0.05)。结论男性,吸烟,高血尿酸水平,糖尿病、冠心病、血脂异常病史的青年更易成为STEMI患者,但青年STEMI患者较中老年患者康复较快,预后相对较好。
Objective To compare the clinical features and prognosis in young patients and middle-aged and elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Methods STEMI patients undergone PCI(n=187)were chosen from the Second Hospital of Hebei Medical University and analyzed retrospectively and given the same drug intervention from Sept.2018 to Dec.2018.All patients were divided,according to age,into young group(n=25,aged≤44)and middle-aged and elderly group(n=162,aged>44).The general materials,relative laboratory indexes,results of cardiac ultrasound,coronary angiography,length of hospital stay and results of cardiac ultrasound after discharged for 3 months were compared between 2 groups.The incidence of MACE and bleeding events were observed after PCI for 1 y.Results The incidence rate was higher,systolic blood pressure and glycated hemoglobin level were relatively lower,albumin level,white blood cell count and platelet count were relatively higher,D-Dimer and cardiac troponin were relatively lower,and uric acid(UA)was relatively higher.After treatment,peak E mitral blood flow velocity/diastolic mitral annular velocity(E/e')was reduced more,numbers of lesion blood vessels and stents were less,length of hospital stay was shorter,and incidence rate of severe heart failure was lower in young group than those in middle-aged and elderly group(P<0.05).Conclusion The male and smoking young people with high UA level and history of diabetes,coronary heart disease and dyslipidemia are more likely to suffer from STEMI,but they will recover more quickly with better prognosis compared with middle-aged and elderly people.
作者
牛绍乾
张晓晴
汪雁博
李伟
傅向华
Niu Shaoqian;Zhang Xiaoqing;Wang Yanbo;Li Wei;Fu Xianghua(Fifth Department of Cardiology,Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;不详)
出处
《中国循证心血管医学杂志》
2021年第9期1100-1103,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
ST段抬高型心肌梗死
经皮冠状动脉介入治疗
青年
中老年
ST-segment elevation myocardial infarction
Percutaneous coronary intervention
Youth
Middle-aged and elderly people
