40岁以下年轻人急性心肌梗塞的冠状动脉病变的探索

Evaluatian of Coronary Artery Lesions in Acute Myocardial Infarction in Youth Under 40 Years Old

为了研究年轻人急性心肌梗塞（AMI）的冠状动脉病变特点，并探讨其病因，32例40岁以下年轻人AMI患者参加了本研究，在发病后4小时～4周内行选择性冠状动脉造影术（CAG）。结果发现：8例（25．0％）CAG正常，且见于下壁AMI，24例（5．0％）共有33处冠状动脉病变，左前降支病变16例，左回旋支病变8例，右冠状动脉病变9例；其中单支病变16例（66．7％），双支病变7例（29．3％），三支病变1例（4．0％）。冠状动脉病变患者多存在危险因素，特别是吸烟（100％）。本文提示，年轻人AMI的主要病因仍是冠状动脉粥样硬化，冠状动脉痉挛次之，且见于下壁AMI。冠状动脉病变多单支受累，且以左前降支为多。

In order to study the characteristics of coronary artery lesion and the Pathoogcal changes of acute myocarial irifartion(AMI) in youth, coronary ineriogrphy (CAG) was performed on 32 cases of AMI in youth (under 40 years old) who had experienced attack within4 hours^4 weeks. Results: 33 spots of coronary artery athemeleroic lesions were found in24 cases (75% ),and CAG was normal in 8 cases(25%). 16 spots were with lesions in leftanterior descending branch, 8 spots with lesious in left circndex branch, 9 spots with lesonsin right comp inery of the patients; Among them 16 cases (66. 7 % ) were with lesions insingle branh, 7 cases (29. 3 % ) with lesons in double branches, and 1 case(4 - 0 % ) was withlesons in three branches. fosk factors especially smoking were frequently occurred (smoking, 100% ) in patient with coronary artery lessions. The present study suggests tha coronary atherosclerosis remains the edn pathogen of AMI in youth, and coronaxy artery spasrnwas the second. Most of the coronaxy artery lesions invove single branch, which is frequentiythe left anterior descending branch.