不同年龄段冠心病患者的临床特征及其危险因素分析

目的:探讨不同年龄段冠心病(CAD)患者的临床特征,并对其危险因素进行分析。方法:采用回顾性研究,选择2010-2014年于我院冠状动脉造影并行介入治疗的冠心病患者480例,其中老年患者(A组)320例,中青年患者(B组)160例。分析两组患者的临床资料、冠状动脉病变情况、疾病类型及术后不良反应发生率,比较两组实验室检查指标,将上述差异有统计学意义的因素带入多元线性回归,分析冠心病的危险因素。结果:(1)A组与B组之间,在性别构成及是否患有高血压病方面比较,差异有统计学意义(P0.05)。(2)A组的单支病变以及三支病变者发生率较B组高,差异有统计学意义(P0.05)。A组患者术后总的不良发生率较中B组多,其中出血、心律失常、心源性休克的发生率也均较中青年组高,差异有统计学意义(P0.05)。(3)A组患者的肌酐(Cr)、血浆凝血酶原时间(PT)、纤维蛋白原(FIB)水平高于B组,谷氨酰转肽酶(GGT)、三酰甘油(TG)、同型半胱氨酸(Hcy)、血小板计数(PLT)水平低于B组,且差异有统计学意义(P0.05)。(4)多因素Logistic回归分析显示,Hcy、FIB是冠心病的危险因素(P0.05)。结论:老年与中青年冠心病患者的临床表现有较大不同,且Hcy、FIB是影响不同年龄段冠心病发病的危险因素,提示在临床治疗冠心病过程中治疗方案应存在一定差异。

Analysis of Clinical Characteristics and Risk Factors between Different Age Patients with Coronary Artery Disease

ABSTRACT Objective: To investigate the clinical characteristics and risk factors between different age patients with coronary artery disease(CAD). Methods: Using retrospective study, 480 CAD patients underwent coronary angiogram and interventional therapy in our hospital from 2010 to 2014 were selected, including 320 cases of elder patients(A group) and 160 cases of young and middle age patients(B group). Clinical data, stenosis of coronary artery, disease types and incidence rate of adverse events were analyzed in two groups, compared the laboratory indexes in two groups, and then multiple linear regression analysis was conducted on factors with statistical sig- nificance in single factor analysis to explore the risk factors of CAD. Results: (1)The sex ratio and hypertension between the A group and B group showed statistically significance difference(P<0.05).(2)The incidence of single and triple vessel disease in the A group was sig- nificantly higher than that of B group(P<0.05). The adverse events in the A group were more than those in the B group,including bleed- ing,arrhythmia and cardiogenic shock(all P<0.05). (3)The creatinine (Cr), plasma prothrombin time (PT), fibrinogen (FIB) in the A group were significantly higher than B group, but gamma-glutamyltransferase (GGT), triacylglycerol (TG), homocysteine (Hcy) and platelet count (PLT) were significantly lower than the B group (P<0.05). (4)Multiple factor regression analysis showed that Hcy and FIB were risk factors of CAD (P<0.05). Conclusion: There were significant difference between different age patients with CAD in the clinical char- acteristics, besides the Hcy and FIB were the risk factors of CAD. It suggests that the treatment should be different for CAD between the elderly and the young,middle-aged patients with CAD.