目的 探讨不同年龄急性心肌梗死(AMI)患者的血脂异常情况及冠状动脉病变特点.方法 将临床确诊AMI的135例患者分为中青年组(年龄35～59岁,59例)、老年组(年龄60～ 74岁,29例)和高龄老年组(年龄75 ～ 87岁,47例)；分析各组患者冠心病(CHD)危险因素、血脂水平和冠状动脉病变特点.结果 冠心病危险因素中,中青年组吸烟史和CHD阳性家族史比例明显高于高龄老年组,而高龄老年组合并高血压的比例明显高于中青年组(P＜0.05).血脂谱分析显示中青年组总胆固醇(TC)、三酰甘油(TG)和载脂蛋白B(Apo B)均显著高于高龄老年组患者(P＜0.05).3组AMI患者检出率最高的血脂异常为高密度脂蛋白(HDL-C)降低.冠状动脉造影显示中青年组单支病变(23.7％)显著多于高龄老年组(4.2％).冠状动脉病变程度用Gensini积分比较,高龄老年组显著高于中青年组和老年组.结论 高脂血症是各年龄组AMI患者最常见的危险因素,特别是HDL-C降低.应重视冠心病患者,特别是中青年患者血脂检测和调脂治疗.%Objective To compare the serum lipid level and coronary angiographic(CAG) findings in different age patients with acute myocardial infarction(AMI). Methods 135 cases with AMI were divided into young-middle-age group,aged group and senile group. The risk factors,serum lipid level and characteristics of CAG findings were analyzed. Results Compraed with aged group and senile group, the ratio of smoking and positive family history were higher in young-middle-age group( P < 0. 05 ) . Compared with young-middle-age group,the rates of hypertention were higher in senile group(P < 0. 05 ). The total cholesterol (TC) , triglyceride (TG) and apolipoprotein B( Apo B) were significantly higher in young-middle-age group. Low HDL-C levels was the most popular dyslipidemia category. Young-middle-age group have more single-vessel diseases than senile group(23.7% vs 4. 2% ). Gensini score of coronary angiog-raphy was highest in senile group(86. 32 ±44.91). Conclusion Dyslipidemia was the most popular risk factors of AMI in different age patients, especially the Low HDL-C levels. Modifing lipid of young and middle age patients would prevent the earlier occurrence of acute myocardial infarction.
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