中国急性心肌梗死患者不同年龄组心血管危险因素分析
Age-related coronary risk factors in Chinese patients with acute myocardial infarction
目的 描述中国不同年龄组急性心肌梗死(AMI)患者心血管危险因素的分布状况.方法 中国急性心肌梗死注册登记(CAMI)研究在2013年1月1日至2014年9月30日期间,共连续入选全国31个省市自治区107家医院从发病至医院就诊时间在7d之内、并填报了完整的危险因素信息的AMI患者24 394例.采用调查问卷收集可干预的危险因素,包括吸烟、超重/肥胖、高血压、血脂异常、糖尿病;不良生活方式包括吸烟、缺乏运动、喜肥腻饮食.将24 394例患者分为< 45岁(2 307例)、45~54岁(4 448例)、55~64岁(7 029例)、65~74岁(6 147例)和≥75岁(4 463例)5个组进行比较.结果 24 394例入选患者平均年龄(62.2士13.8)岁,男性18 162例(74.5%),18 209例(74.6%)为ST段抬高型心肌梗死(STEMI).24.7%的患者合并3个及以上可干预的危险因素.总体而言,随着年龄增加,女性、高血压、糖尿病比例逐渐升高;年轻患者中,吸烟、肥胖/超重、高脂血症比例较高.在<55岁的AMI患者中,男性约占90%.按照年龄分组,从<45岁组到≥75岁组,男性(从92.3%到58.0%)、肥胖/超重(从63.9%到37.4%)、目前吸烟率(从68.7%到19.8%)、合并血脂异常(从9.1%到4.5%)、早发冠心病家族史(从6.2%到1.2%)以及喜肥腻饮食(从86.1%到66.2%)患者的比例均呈现显著下降趋势,在男性患者中上述因素的年龄趋势尤为明显.合并高血压患者的比例呈现显著上升趋势(从34.3%到57.9%);合并糖尿病的比例则呈现先升后降的曲线趋势(< 45岁组最低,为11.1%;65~74岁组最高,为22.1%;≥75岁组则又有所下降,为19.3%).结论 不同年龄组的AMI患者危险因素存在差异,年轻AMI患者合并不良生活方式相关危险因素的比例更高.
更多Objective To determine the age-related coronary risk factors in Chinese patients with acute myocardial infarction (AMI).Methods Among 31 provinces,municipalities or autonomous districts in China,from January 1st 2013 to September 30th 2014,24 394 consecutive AMI patients who were admitted to 107 hospitals were divided into five groups according to age.Cardiovascular risk factors of group Ⅰ (<45 years,n =2 307),group Ⅱ (45-54 years,n =4 448),group Ⅲ (55-64 years,n =7029),group Ⅳ (65-74 years,n=6 147) and group Ⅴ (≥75 years,n =4 463) patients were compared.Results Among 24 394 AMI patients [with a mean age of (62.2 ± 13.8) years,18 162 males],24.7% patients had three and more conventional modifiable cardiovascular risk factors.ST-elevation myocardial infarction (STEMI) was diagnosed in 18 209 (74.6%) patients.The ratios of female,hypertension and diabetes tended to increase with the increase of age.Young AMI patients were predisposed to smoking,overweight/obesity and hyperglycemia.Nearly 90% patients in group Ⅰ and group Ⅱ were male.The ratio of male patients (92.3% to 58.0%),overweight/obesity (63.9% to 37.4%),current smoking (68.7% to 19.8%),dyslipidemia (9.1% to 4.5%),family history of premature coronary artery disease (CAD) (6.2% to 1.2%) and eating greasy food (86.1% to 66.2%) decreased markedly from group Ⅰ to Ⅴ patients.Proportion of hypertension gradually increased from 34.3% in group Ⅰ patients to 57.9% in group Ⅴ patients.Diabetes was most common to group Ⅳ (65-74 years) patients.Conclusion There were different risk factors for AMI patients in different age groups,and young AMI patients were predisposed to live an unhealthy lifestyle.
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