|本期目录/Table of Contents|

[1]张兴虎,张一丹,万文辉,等.45例高龄男性不稳定型心绞痛患者的临床特点分析[J].医学研究与战创伤救治(原医学研究生学报),2019,21(01):39-43.[doi:10.3969/j.issn.1672-271X.2019.01.009]
　ZHANG Xing-hu,ZHANG Yi-dan,WAN Wen-hui,et al.Clinical characteristics of 45 very elderly male patients with unstable angina pectoris[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2019,21(01):39-43.[doi:10.3969/j.issn.1672-271X.2019.01.009]
点击复制

45例高龄男性不稳定型心绞痛患者的临床特点分析()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第21卷
期数:
2019年01期
页码:
39-43
栏目:
临床研究
出版日期:
2019-01-20

文章信息/Info

Title:
Clinical characteristics of 45 very elderly male patients with unstable angina pectoris
作者:
张兴虎; 张一丹; 万文辉; 贡歌; 张瑗; 陈阳希; 朱小蔚
作者单位：210002南京，东部战区总医院干部病房一科（张兴虎、张一丹、万文辉、贡歌、张瑗、陈阳希），干部保健科（朱小蔚）
Author(s):
ZHANG Xing-hu1; ZHANG Yi-dan1; WAN Wen-hui1; GONG Ge1; ZHANG Yuan1; CHEN Yang-xi1;  ZHU Xiao-wei2
（1.Department of Geriatrics, 2.Department of Cadre Health, General Hospital of Eastern Theater Command, PLA， Nanjing 210002, Jiangsu, China）
关键词:
高龄老年人; 男性; 不稳定型心绞痛; 临床特点
Keywords:
very elderly patients; unstable angina pectoris;  stable angina pectoris;  clinical characteristic
分类号:
R541.4
DOI:
10.3969/j.issn.1672-271X.2019.01.009
文献标志码:
A
摘要:
目的 探讨高龄男性（≥80岁）不稳定型心绞痛（UAP）患者的临床特点。方法 回顾性分析2010年1月至2017年5月东部战区总医院45例高龄男性[80~100(89.15±6.43)岁]住院UAP患者（UAP组）临床资料，另以同期39例高龄男性[80~98（87.60±7.03）岁]稳定型心绞痛患者（SAP组）作为对照，分别观察2组吸烟史、饮酒史、冠心病家庭史、高血压史、2型糖尿病史、心律失常史和高脂血症史等情况，检测2组患者的外周血胆固醇、低密度脂蛋白（LDL-C）、糖化血红蛋白（HbA1c）、高敏C反应蛋白（Hs-CRP）、同型半胱氨酸（Hcy）、B型利钠肽（BNP）水平、冠状动脉造影显示重度狭窄（＞75%）的发生率、leaman评分、药物和介入治疗情况及1年内心源性死亡率，并进行组间比较。结果 高龄男性UAP组和SAP组外周血LDL-C[（3.83±0.98）mmol/L vs （2.63±0.81）mmol/L]、Hs-CRP[（8.87±6.69）mg/L vs （4.21±5.13）mg/L]、Hcy[（18.12±5.57）μmol/L vs （14.34±8.70）μmol/L]和BNP[（378.23±145.81）ng/L vs （202.28±115.34）ng/L]水平，右冠状动脉(RCA)（13.33% vs 5.13%）、左前降支(LAD) （20.00% vs 10.25%）及2支或2支以上（11.11% vs 2.56%）重度狭窄的发生率，冠脉leaman评分[(10.26±2.89) vs (5.63±1.71)]，介入治疗（26.67% vs 15.38%）,1年内心源性死亡率（13.33% vs 7.69%）, 差异均有统计学意义（P<0.05）。回归分析示，LDL-C、Hs-CRP、Hcy与leaman评分呈线性相关关系，差异有统计学意义(P<0.05)。结论 LDL-C、Hs-CRP、Hcy、BNP水平及leaman评分与高龄男性老年UAP的发病关系密切，而且其右冠脉和左前降支冠脉狭窄尤为突出，常合并有多支病变，近期死亡率高。
Abstract:
Objective To investigate the clinical characteristics of the very elderly male patients with unstable angina pectoris (UAP).Methods Forty-five cases of the very elderly (80-100 years old, an average of 89±6.43)male patients with UAP were regarded as the observation group. Thirty-nine cases of the very elderly (80-98 years old, an average of 87±7.03) patients with stable angina pectoris (SAP) were regarded as the control group. All patients were observed the history of the family coronary heart disease, hypertension, type 2 diabetes, arrhythmia, hyperlipidemia, drinking and smoking. Cholesterol, low density lipoprotein (LDL-C), glycosylated hemoglobin (HbA1c), high-sensitivity c-reactive protein (Hs-CRP), homocysteine (Hcy), B type natriuretic peptide (BNP) level and severe stenosis showed by coronary angiography (coronary artery diameter stenosis percentage more than 75%)，coronary leaman score, drug and interventional treatment, and cardiac mortality within 1 year were examined in the two groups of patients, respectively.Results The levels of peripheral blood LDL-C[（3.83±0.98）mmol/L vs （2.63±0.81）mmol/L], Hs-CRP[（8.87±6.69）mg/L vs （4.21±5.13）mg/L], Hcy[（18.12±5.57）μmol/L vs （14.34±8.70）μmol/L], BNP[（378.23±145.81）ng/L vs （202.28±115.34）ng/L] , and the incidence of severe coronary stenosis of right coronary artery (RCA) （13.33% vs 5.13%）, left anterior descending branch (LAD) （20.00% vs 10.25%）, and two or more than two branchs of coronary artery（11.11% vs 2.56%），coronary leaman score [(10.26±2.89) vs (5.63±1.71)], interventional therapy (26.67% vs 15.38%), cardiac mortality within 1 year (13.33% vs 7.69%) were obviously higher in the very elderly male patients with UAP group than that in SAP group, multiple regression analysis showed that LDL-c, Hs-CRP, Hcy had a linear correlation with leaman score (P<0.05).Conclusion The levels of peripheral blood LDL-C, Hs-CRP, Hcy，BNP and coronary leaman score were closely related to the incidence of UAP in the very elderly male patients. Their right coronary artery and left anterior descending branch lesions are particularly prominent, and often associated with multiple lesions, and which is relatively high recent mortality rate.

参考文献/References:

[1]Loh JP,Kpendyala LK,Kitabata H,et al.Comparison of outcomes after percutaneous coronary intervention among different coronary subsets (stable and unstable angina pectoris and ST-segment and non-ST-segment myocardial infarction [J].Am J Cardiol，2014，113（11）：1794-1801.
[2]李淑玲，朱成朔，刘国安.不稳定型心绞痛的发病机制与药物治疗进展[J].世界中西医结合杂志，2013，8（2）：210-212.
[3]Odden MC，Coxson PG，Moran A，et al. The impact of the aging population on coronary heart disease in the United States［J］. Am J Med，2011，124（9）：827-833.
[4]邢冉.阿司匹林、替格瑞洛联合应用在不稳定型心绞痛治疗中的效果探讨[J].中国实用医药,2017,12(36):106-108.
[5]刘柯婷，周淑宇，蔡必扬，等.高敏C反应蛋白和大动脉粥样硬化型卒中严重程度的相关性研究[J].医学研究生学报，2015,28(10):1043-1047.
[6]王苏梦，吴嘉，牛冬梅，等.急性冠脉综合征患者NT-proBNP、RDW和CRP的水平及相关性研究[J].东南国防医药,2015,17(4)：362-364.
[7]Sheikh AS,Yahya S,Sheikh NS,et al. C-reactive protein as a predictor of adverse outcome in patients with acute coronary syndrome[J].Heart Views,2012,13(1):7-12.
[8]周函，徐健，黄文胜，等.稳定型心绞痛和不稳定型心绞痛与同型半胱氨酸水平的相关性[J].中国老年医学，2016，36（9）：2099-2101.
[9]苑小历，游云鹏，潘士勇，等.MTHFR基因多态性及同型半胱氨酸与老年冠心病的相关性[J]. 东南国防医药,2012,14(4)：320-321，365.[1]0]Stone NJ,Robinson JG,Lichtenstein AH,et al.2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults a report of theAmerican college of cardiology/American heart association task force on practice guideline[J].J Am Coll Cardiol,2014,63(25B):2889-2934.[1]1]汪俊军.脂蛋白检测的现状和发展趋势[J]. 医学研究生学报，2016,29(1):10-15.[1]2]Welsh P,Doolin O,Willeit P,et al.N-terminal pro-B-type natriuretic peptide and the prediction of primary cardiovascular events:results from 15-year follow-up of WOSCOPS[J].Eur Heart J,2013,34(6):443-450.[1]3]刘鹏，王博雅，王学静，等.不同年龄段老年急性冠脉综合征患者的心功能状况分析[J].中国心血管病研究,2018,16(5):435-438.[1]4]张明，侯建伟.外周血脑钠肽，超敏C反应蛋白与冠脉血管病变的相关性研究[J].陕西医学杂志,2016,45(1):110-111，114.[1]5]杨波，高玉梅，商鲁翔，等.老年冠心病患者血尿酸与冠状动脉狭窄程度的相关性[J].中华老年心血压病杂志，2016，18（8）：812-814.[1]6]王华，方芳，柴坷，等.老年急性心肌梗死死亡病例的心脏病理特点分析[J]. 中华心血管病杂志，2017，45（7）：591-596.

相似文献/References:

[1]吴渊文,宋文全.抗精子抗体与解脲支原体在不育症中检测的意义[J].医学研究与战创伤救治(原医学研究生学报),2011,13(03):253.

备注/Memo

备注/Memo:
基金项目：全军保健专项科研课题（17BJZ17）
更新日期/Last Update: 2019-01-20