| Objectives: Acute myocardial infarction(AMI) is a disease of acute myocardial ischemic necrosis.On the basis of coronary artery disease, if coronary blood supply is drastically reduced or interrupted, the corresponding myocardial was led to myocardial necrosis because of the serious and continuous acute ischemia.There are many clinical manifestations of AMI,such as enduring and severe retrosternal pain, fever, increase of white blood cell count and markers of serum necrosis and progressive change of ECG. Arrhythmias, shock or heart failure may occur. It is a serious type of acute coronary syndrome(ACS). At present, AMI has become one of the most common cardiovascular disease in today’s society,which is serious harm to human health,affecting the quality of people life.It is also one of important diseases in global scope that lead to disability, death.AMI used to occur in the elderly, but in recent years, because of the improvement of living standards, the accelerated pace of life, increased work pressure, changes in lifestyle and diet, age of onset of AMI has been lowered. The incidence of young AMI is increasing year by year, so people gradually pay more attention to the pathological characteristics, clinical laboratory test results and prognosis. By analyzing clinical characteristics, disease features and pathological features of coronary of different age grades AMI patients,this research aims to offer help for different age grades AMI clinical diagnosis,treatment and prognosis,and aslo to offer help to prevent the young AMI.Methods: We select 720 cases of diagnosed AMI patients who accepted hospitalization from October 2010 to October 2013 in Bethune international Heping Hospital. According to Age Determination newly confirmed by World Health Organization in 2013,we divide the patients into three groups,the 67 patients under the age of 44 years old are in the young group, 61 cases are male and 6 is female.The 228 patients who are older than 44 and younger than 60 are in middle age group,211 cases are male and 17 are female.The 425 patients who are older than 59 years old are in the elderly group, 251 cases are male and 174 are female.All patients meet the AMI diagnosis and treatment guidelines revised by Angiocardiopathy Branch of Chinese Medical Association in 2001. According to the proportion,age and gender of three groups,we analyze retrospectively general epidemiological situation. According to the proportion of hypertension, diabetes, hyperlipidemia, stroke, smoking,alcoholism,positive family history, heart disease history in every group,we analyze clinical characteristics in three groups. According to the ECG ST-segment elevation and concurrent left heart failure,arrhythmia of patients in three groups,we analyze disease features of AMI.According to thecoronary angiography results( lesion, number of the blood vessels involved) of patients in three groups,we analyze pathological features of coronary.Results: 1. AMI is more prevalent in the elderly group.The male AMI patients in the three groups have high prevalence, especially in young and the middle age group(P<0.05). Analyzing clinical characteristics in three groups,there is a higher proportion in every group with hypertension,and diabetes, hyperlipidemia, stroke, smoking,alcoholism,positive family history, heart disease history is also prevalent. The proportion of patients with smoking in young and middle age group has statistical significance compare with the ederly group(P<0.05). but in the elderly group,they usually accompany with stroke and heart disease history. 2. The ST-segment elevation myocardial infarction patients in the three groups have a high proportion. The non-ST-segment elevation myocardial infarction in youth group and the middle age group is less than that in elderly group(P<0.05).The myocardial infarction ECG leads elevation in three groups are mainly the anterior wall,especially in young group and the middle age group, which is of statistical significance(P<0.05). The anterior wall ST-segment elevation in three groups elevates the most,followed by that of anteroseptal and inferior wall myocardial infarction.The patients of myocardial infarction with multi-wall ST-segment elevation in every group has not statistically significant(P>0.05).The number of cases of arrhythmia and left heart failure in the middle age group and the elderly group is bigger than that in young group(P<0.05).3. There are more narrow single vessel diseases involved in young group and the middle age group, while there are more multivessel diseases involved in elderly group. The comparison between them is statistically significant(P<0.05). The lesions of anterior descending coronary artery are involved greatly in three groups, especially obvious in young group and the middle age group(P<0.05).Followed by the right coronary artery lesions.Conclusions:(1) AMI is more prevalent in the elderly.At present,age of onset of AMI has been lowered, and the males are more susceptible, especially in younth and the middle age.(2) AMI pstients usually accompany with hypertension, diabetes, hyperlipidemia, stroke, smoking,alcoholism, positive family history, heart disease history, the hypertension is more prevalent. There is a higher proportion in younth and the middle age with smoking.but in the elderly,they usually accompany with multiple risk factors.(3)In the respect of AMI clinical characteristics, the ECG of acute anterior wall myocardial infarction in young and the middle age patients are mostly ST-segment elevation myocardial infarction.There are less arrhythmia and left heart failure after myocardial infarction in young group compared with the middle age group and the elderly group.(4)In the younth and the middle age, single-vessel coronary disease are more and anterior descending coronary artery takes the most.There are less multivessel lesions, diffuse lesions and other serious coronary artery disease lesions in younth and the middle age compared with the elderly, so the prognosis of interventional treatment is good. |
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