青年人急性心肌梗死的临床特征及冠脉造影结果分析

Coronary angiography and clinical characteristics of acute myocardial infarction in young patients

目的观察青年人急性心肌梗死(AM)I的危险因素、临床表现及冠状动脉病变特点,探讨青年人发生AMI的易患因素,为预防青年人发生AMI提供理论依据。方法观察收住院的首次AMI患者(青年人组76例;老年组80例),对两组间的主要危险因素(吸烟、高血压、血脂异常、糖尿病、冠心病阳性家族史、肥胖及饮酒史等)及冠状动脉病变特点等进行对比分析。结果青年组中吸烟有54例(71.1%)、高甘油三脂血症24例(31.6%)、冠心病家族史11例(14.5%)、肥胖20例(26.3%)及长期大量饮酒史45例(59.2%)均高于老年组(P<0.05);青年组以男性为主(88.2%)。冠状动脉造影检查青年组单支冠脉病变比例明显高于老年冠心病组,两支及三支冠脉病变所占的比例明显低于老年冠心病组(P<0.01)。结论青年人AMI有较多的冠心病危险因素,冠心病阳性家族史及肥胖是青年人发生AMI最主要的重要危险因素之一;青年AMI患者临床症状典型,以单支病变为主,并发症少,预后较好。

Objective To evaluate infarction risk factors, clinical manifestations and the characteristics of coronary artery disease of the young with AMI. Methods Patients were selected from July 2007 to December 2008, and divided into young group with AMI （age ≤45 years, n=76） and older group with AMI （age ≥ 60 years, n=80）. The main risk factors （smoking, hypertension, dyslipidemia, diabetes, positive family history of coronary heart disease, obesity and alcohol consumption history） were compared in two groups. Clinical characters and coronary leson levels were compared and analyzed. Results Among the young group, there were 54 （71.1%） patients with a history of smoking, 24 （31.6%） hypertriglyceridemia, 11 （14.5%） family history of CHD, 20 （26.3%） obesity and 45 （59.2%） alcohol abuse, each of these was higher than that of older group. Most young patients with AMI were men （88.2%）. Coronary angiogram showed that the young group mainly had single vessel disease. Proportion of 2 and 3 vessel disease in young group was obviously less than that of the old group （P〈0.01）. Conclusion There are more risk factors in the young patients with AMI. Family history of CHD and obesity are the most of risk factor. Most of them have typical symptom, less complication and better progrosis. The disease is mainly single vessel one.