Kröger K, Buss C, Goyen M, Renzing-Köhler K, Rudofsky G
Department of Angiology, University Hospital Essen, Germany.
Int Angiol. 2000 Sep;19(3):206-11.
Risk factors and especially the combination of multiple risk factors are associated with the development of atherosclerosis. Therefore, patients with an early manifestation of atherosclerotic disease are likely to show an extraordinary risk profile. We analysed the frequencies and severity of risk factors in young patients with manifest peripheral arterial occlusive disease as compared to old patients.
We analysed the risk profiles in 303 patients who were sent for interventional treatment of a symptomatic peripheral arterial occlusive disease. The risk profiles were described for different age groups (54 patients under 50 years of age, 194 patients from 51 to 74 years, 55 patients over 75 years). Multiple linear regression analysis and analysis of variance were performed to look for age-dependent effects.
Elevated total cholesterol, and triglyceride levels and nicotine abuse were more frequent in patients younger than 50 years. Diabetes mellitus and hypertension were more frequent in patients older than 75 years. The different frequencies for smoking, diabetes mellitus and hypertension were age-related (p<0.05). Concerning laboratory parameters such as HDL- and LDL-cholesterol, fibrinogen, lipoprotein(a) and homocysteine there were no relevant age-related differences in frequency nor in absolute values with the exception of the hematocrit and uric acid. The coincidence with clinically manifest myocardial infarction was 11.15% in the patients under 50 years compared to 20.6% in those aged 51-74 years and 16.4% in those over 75 years, for cerebral stroke it was 5.6%, 17.5% and 14.5%, respectively. Patients under 50 years with peripheral arterial occlusive disease and a history of myocardial infarction were characterised by high levels of total cholesterol, triglyceride and lipoprotein(a). Excluding patients with prior myocardial infarction patients did not show any difference in risk profile between the three age groups.
In a population suffering from manifest peripheral arterial occlusive disease the risk profile in patients under 50 years is not different from that in older patients. In contrast an additional myocardial infarction in such a population is associated with pathological lipid profiles.
风险因素尤其是多种风险因素的组合与动脉粥样硬化的发生相关。因此，动脉粥样硬化疾病早期表现的患者可能具有特殊的风险特征。我们分析了有明显外周动脉闭塞性疾病的年轻患者与老年患者风险因素的频率和严重程度。
我们分析了303例因有症状的外周动脉闭塞性疾病而接受介入治疗患者的风险特征。描述了不同年龄组（54例年龄在50岁以下，194例年龄在51至74岁，55例年龄在75岁以上）的风险特征。进行多元线性回归分析和方差分析以寻找年龄依赖性效应。
50岁以下患者总胆固醇、甘油三酯水平升高及尼古丁滥用更为常见。75岁以上患者糖尿病和高血压更为常见。吸烟、糖尿病和高血压的不同频率与年龄相关（p<0.05）。关于实验室参数如高密度脂蛋白和低密度脂蛋白胆固醇、纤维蛋白原、脂蛋白(a)和同型半胱氨酸，除血细胞比容和尿酸外，频率和绝对值均无相关的年龄相关差异。50岁以下患者临床明显心肌梗死的发生率为11.15%，51 - 74岁患者为20.6%，75岁以上患者为16.4%；对于脑卒中，分别为5.6%、17.5%和14.5%。有外周动脉闭塞性疾病且有心肌梗死病史的50岁以下患者，其总胆固醇、甘油三酯和脂蛋白(a)水平较高。排除有心肌梗死病史的患者后，三个年龄组患者的风险特征无差异。
在患有明显外周动脉闭塞性疾病的人群中，50岁以下患者的风险特征与老年患者无异。相比之下，该人群中额外发生心肌梗死与异常脂质谱相关。
