目的: 探讨高龄急性心肌梗死病人临床特征及冠状动脉病变特点。方法: 研究80 例高龄老年人发
生急性心梗时冠心病危险因素、心电图特征、心功能变化、冠状动脉病变特点及心脏意外事件，以与老年组进行
比较。结果: ( 1) 胱抑素( CysC) 水平观察组高于对照组( P＜0．001) 。脂蛋白( a) ［LP( a) ］水平高于对照组，但无
统计学意义( P＞0．05) 。( 2) 观察组射血分数( EF%) 值明显低于对照组( P＜0．001) ; 脑钠肽前体( NT－proBNP) 明
显高于对照组( P＜0．001) 。( 3) 广泛前壁心梗观察组较对照组多( P＜0．05) 。( 4) 观察组严重临床事件都高于对
照组( P＜0．05) 。结论: 80 岁以上高龄病人较80 岁以下的老年人，以广泛前壁心梗多见，心梗面积大，收缩功能
差，更易出现心衰。临床严重事件明显增高。CysC 在高龄病人中增高明显，亦提示冠脉病变重，病情严重。

Objective: to study clinical features and coronary artery lesions in older elderly patients
with acute myocardial infarction( AMI) ．Methods: 80 AMI older elderly patients were compared
with elderly group in coronary heart disease risk factors、electrocardiogram、heart function change、the
coronary artery lesion characteristics and cardiac accidents．Results: ( 1) Cystatin C( CysC) level of
observation group is higher than the control group( P＜0．001) ．Lipoprotein( a) ［LP( a) ］level is also
higher than the control group，but no statistical significance( P＞0．05) ．( 2) Ejection fraction( EF%) of
the observation group is significantly lower than the control group( P＜0．001) ; N－terminal probrainnatriuretic
peptide( NT－proBNP) is significantly higher than the control group( P＜0．001) ．( 3) Extensive
anterior myocardial infarction of observation group is more than the control group( P ＜ 0．05) ．
( 4) Severe clinical events of observation group are higher than the control group( P＜0．05) ．Conclusion:
Compared with elderly people under the age of 80，patients above 80 years old are more
likely suffering extensive anterior myocardial infarction．Myocardial infarction area is larger，the systolic
function being poorer and prone to heart failure． Clinical severe events are increased signifi-
cantly．CysC in older elderly patients increased significantly，which also shows heavy coronary lesions
and severe illness．

R541．4

 收稿日期: 2016－11－01; 修回日期: 2016－12－10
基金项目: 内蒙古自治区高等学校科学研究项目( NJZZ097)
作者简介: 李爱英( 1971－) ，女，内蒙古医科大学附属医院心内科主任医师，医学硕士。