摘要
目的 分析急性心肌梗死(AMI)患者的年龄和住院期间预后的关系。方法 回顾2013年4月至2017年4月于首都医科大学附属北京友谊医院冠心病监护病房接受诊治的1370例AMI患者的临床资料。按年龄分为5组:≤45岁组(96例),≤55岁组(296例),≤65岁组(409例),≤75岁组(275例),>75岁组(294例)。对各组患者住院期间的基线资料、冠状动脉(冠脉)影像学特征、心功能指标、估测心肌梗死面积、主要不良心血管事件(MACE)进行比较分析,研究各项指标的年龄分布特征。结果 随着年龄的增加,AMI发病率有增加趋势,55~65岁为AMI的高发年龄段;男性比例逐渐下降,高血压和糖尿病患病率逐渐增加,体质指数、吸烟率和饮酒率逐渐减少;冠脉狭窄程度(Gensini积分)增加(P<0.05);心功能逐渐变差,各年龄组之间估测心肌梗死面积(以肌钙蛋白峰值表示)未见明显差异(P<0.05);MACE事件有增多趋势,住院时间有延长趋势(P<0.05)。回归分析进一步证实了随着年龄增加,心功能变差逐步加重,MACE事件逐渐增加(P<0.05)。结论 年轻心肌梗死患者中男性比例较高,与不良生活方式有关,但高血压和糖尿病患病率低、冠脉狭窄程度轻、心功能好、MACE事件少。高龄心肌梗死患者则具有相反的趋势。
Objective To analyze the relationship between age and in-hospital prognosis in patients with acute myocardial infarction(AMI). Methods The clinical materials of AMI patients(n=1370) were retrospectively collected and analyzed in Beijing Friendship Hospital affiliated to Capital Medical University from Apr. 2013 to Apr. 2017. All patients were divided, according to age, into age≤45 group(n=96), age≤55 group(n=296), age≤65 group(n=409), age≤75 group(n=275) and age>75 group(n=294). The baseline data, coronary imaging characteristics, assessment of heart function, estimated area of myocardial infarction(MI) and major adverse cardiovascular events(MACE) were compared and analyzed in all groups during hospitalization. The characteristics of age distribution of all indexes were studied in all groups. Results With the increase of age, AMI incidence rate showed an ascending trend, AMI was most frequent from age 55 to age 65, male percentage decreased gradually year by year, incidence rates of hypertension and diabetes increased year by year, rates of smoking and drinking decreased gradually, severity of coronary artery stenosis(Gensini integrals) increased(P<0.05), heart function become poor gradually, the estimated area of myocardial infarction(showed by troponin peak value) had no significant differenceamong all groups(P<0.05), and MACE and length of hospital stay had increase trends(P<0.05).The results of regression analysis confirmed that heart function gradually worsened and MACE increased gradually with the increase of age(P<0.05). Conclusion In younger AMI patients, percentage of male cases is higher, AMI is related to adverse lifestyle, while the incidence rates of hypertension and diabetes are lower, severity of coronary artery stenosis is mild, heart function is better, and MACE is less.
作者
王刚
范继红
刘江红
刘锐锋
Wang Gang;Fan Jihong;Liu Jianghong;Liu Ruifeng(Department of Cardiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;不详)
出处
《中国循证心血管医学杂志》
2022年第12期1448-1451,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
国家自然科学基金青年基金(81600276)。
关键词
急性心肌梗死
年龄
院内预后
Acute myocardial infarction
Age
In-hospital prognosis
