摘要
目的观察不同年龄患者的冠状动脉粥样硬化特征，分析其危险因素及病变特点。方法回顾性分析天津市胸科医院1986年2月至2011年12月87例尸检证实的冠状动脉粥样硬化患者的临床病理资料，按20～〈40、40-〈60和≥60岁3个年龄段对冠状动脉狭窄程度和急性冠状动脉综合征的心脏病理学改变、易损斑块发生情况及形态学特点进行比较分析。结果87例患者中，男56例，女31例；年龄23～80岁，平均66．8岁，其中20～〈40岁12例，40～〈60岁24例，≥60岁5l例。冠状动脉狭窄等级在不同性别的差异有统计学意义（P〈0．05），在以上3个年龄段间的差异均无统计学意义（均P〉0．05）。急性冠状动脉综合征患者以上3个年龄段中大脂核所占比例分别为23．5％、38．5％、53．8％（x2=6．282，P=0．043），薄纤维帽所占比例分别为29．4％、41．0％、58．8％（X2=6．589，P=0．037），炎细胞浸润所占比例分别为58．8％、69．2％、85．0％（x。=7．435，P=0．024），钙化形成所占比例分别为35．3％、56．4％、71．3％（x2=8．599，P=0．014）。以上3个年龄段患者易损斑块检出率分别为76．5％、84．6％、88．8％（x2=1．850，P=0．397）。结论不同性别和年龄的患者冠状动脉病变特征和危险因素不同，提示应重视对年轻患者及冠脉轻度狭窄伴易损斑块患者的早期诊断和合理治疗。
Objective To explore the features of coronary atherosclerosis among the patients at different ages and examine their risk factors and pathological characteristics. Methods Retrospective analysis was performed for the clinicopathologic data of 87 patients with coronary atherosclerosis confirmed through autopsy from February 1986 to December 2011 at our hospital. They were divided into 3 groups according to age （20 - 〈40 years, n = 12; 40 - 〈60 years, n =24; 〉60 years, n =51）. Comparative analysis was performed for the degree of coronary artery stenosis and cardiac pathological changes, vulnerable plaque occurrence and morphological features of acute coronary syndrome among different patient groups. Results There were 56 males and 31 females with a mean age of 66. 8 years （ range ： 23 - 80）. Great statistical differences existed in the degree of coronary artery stenosis between different genders （P 〈 0. 05） while there was no significant difference among the above age groups （P 〉 0. 05 ）. In the above age groups of patients with acute coronary syndrome, the incidence of big lipid core was 23.5%, 38. 5% and 53.8% （x2 = 6. 282, P = 0. 043）, that of thin fibrous cap 29. 4% , 41.0% and 58. 8% （x2 = 6. 589, P = 0. 037 ）, that of inflammatory cell in 2 filtration 58. 8%, 69. 2% and 85.0% （X2 = 7. 435, P = 0. 024） and that of calcification formation 35.3% i 56.4% and 71.3 % respectively （x2 = 8. 599, P = 0. 014）. And the incidence of vulnerable plaque occurrence was 76. 5%, 84. 6% and 88.8% （ x2 = 1. 850, P = 0. 397 ） in the above age groups. Conclusions The features and risk factors of coronary atherosclerosis are different according to different ages and genders. Thus we should pay more attention to the early diagnosis and reasonable treatments of young patients and those with both mild coronary stenosis and vulnerable plaque.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第2期119-122,共4页
National Medical Journal of China
基金
天津市卫生局科技基金（2011KZ59）
