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目的:研究青年人急性冠脉综合征(acute coronary syndrome,ACS)患者的临床特点、冠状动脉病变特点及经皮冠状动脉介入治疗(percutaneous coronary invention,PCI)的疗效特点,探讨如何防治青年人的冠心病(coronary heart disease,CHD)。方法:从经冠脉造影(coronary angiography,CAG)确诊为ACS并行PCI的患者1014例中选择所有年龄≤45岁为A组,共59例;年龄≥65岁为B组,共531例。从危险因素、诱发因素、临床特点、冠脉病变程度及PCI的疗效来进行回顾分析。结果:A组患者发病前均有明显诱发因素(86.44%比43.5%,P=0.0000);B组多合并高血压(16.95%比46.33%,P=0.0000)、糖尿病(6.78%比27.68%,P=0.0005)、高尿酸血症(18.64%比49.53%,P=0.0000)。A组单支病变发生率高(72.88%比35%,P=0.0000),而B组多支病变发病率高(11.86%比26.93%,P=0.0117),慢性钙化性病变(CTO)发生率高(5.08%比25.42%,P=0.0005),且侧支循环形成多(18.64%比38.42%,P=0.0028)。A组手术成功率高,术后并发症很少,而B组手术成功率较A组低,术后并发症多。结论:大量饮酒、吸烟、高脂血症及家族遗传因素是年青冠心病患者不可忽视的危险因素;年青的ACS患者手术成功率高,应积极行PCI术。
Objective: To study the clinical features of young patients with acute coronary syndrome (ACS), the characteristics of coronary lesions and the therapeutic effects of percutaneous coronary invention (PCI), and to explore how to prevent and treat young people Coronary heart disease (CHD). Methods: A total of 59 patients (aged 45 or older) were enrolled in group A from 1014 patients who were diagnosed as ACS with PCI by coronary angiography (CAG). From the risk factors, predisposing factors, clinical features, degree of coronary lesions and the efficacy of PCI to conduct a retrospective analysis. Results: The patients in group A had obvious predisposing factors before onset (86.44% vs 43.5%, P = 0.0000), those in group B had more hypertension (16.95% vs 46.33%, P = 0.0000), diabetes (6.78% vs 27.68% P = 0.0005), hyperuricemia (18.64% vs 49.53%, P = 0.0000). The incidence of single vessel disease in group A was higher (72.88% vs 35%, P = 0.0000), while the incidence of multiple vessel disease in group B was higher (11.86% vs 26.93%, P = 0.0117). The incidence of chronic calcified lesions (5.08% vs 25.42%, P = 0.0005), and collateral circulation formed more (18.64% vs. 38.42%, P = 0.0028). A group of high success rate of surgery, postoperative complications rarely, while the success rate of surgery in group B lower than the A group, postoperative complications. Conclusion: A large number of drinking, smoking, hyperlipidemia and family genetic factors are risk factors for young patients with coronary heart disease. The success rate of young patients with ACS is high, and PCI should be actively performed.