青老年急性心肌梗死患者左心室功能分析

摘要

目的 探讨青老年急性心肌梗死后的左心室功能.方法 对本院收治的94例青年和111例老年心肌梗死患者进行一般临床资料采集,记录患者入院的即刻血糖水平、血脂水平、尿酸水平、肌酸激酶同工酶(CK-MB)峰值、梗死部位、处理方法,住院期间心血管事件严重心律失常、死亡心功能KiHip分级、所有患者定期进行超声心动图检查.结果 青年组TG、CK-MB峰值高于老年组[(2.2±0.4) mmol/L比(1.4±0.6) mmoL/L,(190 ±42) U/L比(86±20)U/L,P＜0.05或P＜0.01],前壁心肌梗死比例高于老年组[39.4％(37例)比20.7％(23例)],心功能Killip分级优于老年组[(1.7±0.6)比(2.3±0.8),P＜0.05],病死率低于老年组[4.2％(4例)比13.5％(15例)]；冠状动脉造影显示青年组单支病变多于老年组[50.0％(35/70)比28.9％ (23/76)] (P ＜0.01),而老年组多支病变多于青年组；心肌梗死对青年组的舒张功能、收缩功能的影响小于老年组(P＜0.05).结论 年龄、性别、CK-MB酶峰、入院即刻血糖水平是青年组左心室功能的主要影响因素；年龄、急诊PCI、CK-MB峰值、入院即刻血糖水平是老年组左心室功能的主要影响因素.%Objective To explore left ventricular function for young people and old people with acute myocardial infarction.Methods General clinical data of 94 cases of young people and 111 cases elderly patients with myocardial infarction received in our hospital were collected.The immediately blood glucose levels,lipid levels,uric acid levels,creatine kinase isoenzymes peak,infarction,treatment and cardiovascular events during hospitalization which included serious arrhythmia,Killip class of heart function and death rates were recorded.All patients had echocardiography periodically.Results The triglycerides and creatine kinase isoenzyme (CK-MB) peak in young group are higher than those in the older group [(2.2 ± 0.4) mmol/L vs (1.4 ± 0.6) mmol/L,(190 ± 42) U/L vs (86 ± 20) U/L,P ＜ 0.05 or P ＜ 0.01],and the anterior myocardial infarction is more common [39.4％ (37 cases)vs 20.7％ (23 cases)] ; the Killip class of heart function was better and the mortality was lower [4.2％ (4 cases)vs 13.5％ (15 cases)] compared to the older group.Coronary angiography showed the young group mostly had single-vessel disease[50.0％ (35/70) vs 28.9％ (23/76)] (P ＜ 0.01) and the elderly group had multi-vessel disease.The influence of myocardial infarction for the diastolic function and contractile function in the young group was lower than that the old group (P ＜ 0.05).Conclusions Age,gender,CK-MB enzyme peak and hospitalized immediately blood sugar levels are the main factors of left ventricular function for the young group.Age,emergent PCI,CK-MB enzyme peak,hospitalized immediately blood sugar levels are the main factors of left ventricular function for the old group.