中青年急性ST段抬高型心肌梗死患者的临床特点研究

发布时间：2018-05-24 00:35

本文选题：心肌梗死 + 冠状血管造影术　；参考：《中国全科医学》2017年26期

【摘要】：目的探讨中青年急性ST段抬高型心肌梗死患者的临床特点。方法选取2016年首都医科大学附属北京天坛医院心血管内科明确诊断为急性ST段抬高型心肌梗死、发病12 h内或不超过24 h符合急诊血运重建指征并行急诊经皮冠状动脉内介入治疗(PCI)的患者183例,回顾性分析患者一般临床资料、冠状动脉造影指标、实验室检查指标、心脏功能和结构指标及术后30 d内主要不良心血管事件发生率。结果根据年龄分成中青年组(60岁)95例和老年组(≥60岁)88例。中青年组与老年组患者性别、发病后就诊时间、既往糖尿病病史、早发心血管病家族史、吸烟指数、体质指数比较,差异均有统计学意义(P0.05)。中青年组患者术后静脉使用替罗非班比例及总剂量高于老年组,主动脉内球囊反搏(IABP)比例低于老年组,三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、超敏肌钙蛋白I(hs-c Tn I)、肌酸激酶同工酶(CK-MB)、脑钠肽(BNP)水平高于老年组,血肌酐水平、心功能Killip分级低于老年组(P0.05)。中青年组患者术后30 d内主要不良心血管事件发生率低于老年组,其中恶性心律失常发生率低于老年组(P0.05)。结论中青年急性ST段抬高型心肌梗死患者发病后就诊及时,冠状动脉造影病变相对较轻,血管开通成功率高,预后较好,应积极介入治疗改善其预后。
[Abstract]:Objective to investigate the clinical features of young and middle-aged patients with acute St segment elevation myocardial infarction. Methods Acute ST-segment elevation myocardial infarction was diagnosed as acute ST-segment elevation myocardial infarction in the Department of Cardiovascular Medicine of Beijing Temple of Heaven Hospital affiliated to Capital Medical University in 2016. 183 patients who met the emergency revascularization indication and percutaneous coronary intervention (PCI) within 12 hours or not more than 24 hours after onset were retrospectively analyzed for general clinical data, coronary angiography and laboratory examination. Cardiac function and structure and the incidence of major adverse cardiovascular events within 30 days after operation. Results according to the age, 95 cases were divided into middle and young group (n = 95) and aged group (n = 88). There were significant differences in sex, time after onset, history of diabetes mellitus, family history of early cardiovascular disease, smoking index and body mass index between young and middle-aged group (P 0.05). The proportion and total dose of tirofiban in the young and middle-aged group after operation were higher than those in the elderly group, and the ratio of IABP in the intra-aortic balloon pump group was lower than that in the elderly group. The serum creatinine level, low density lipoprotein cholesterol (LDL-Cn), I(hs-c TNI, creatine kinase isoenzyme (CK-MBN), brain natriuretic peptide (BNPs) were significantly lower in the aged group than in the elderly group. The serum creatinine level and cardiac function Killip grade were lower than that in the elderly group. The incidence of major adverse cardiovascular events in the young and middle-aged group was lower than that in the elderly group within 30 days after operation, and the incidence of malignant arrhythmia was lower than that in the elderly group (P 0.05). Conclusion Young and middle-aged patients with acute ST-segment elevation myocardial infarction should be treated in time, coronary angiographic lesion is relatively light, the success rate of angioplasty is high, and the prognosis is better. Therefore, interventional therapy should be actively used to improve the prognosis of patients with acute ST-segment elevation myocardial infarction.
【作者单位】：首都医科大学附属北京天坛医院心血管内科;
【分类号】：R542.22

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