青年急性心肌梗死患者的临床特点分析

Clinical characteristics of young adult patients with acute myocardial infarction

目的分析青年人(<45岁)急性心肌梗死(acute myocardial infarction,AMI)发病的临床表现特点和冠状动脉病变特点,探讨其病因及防治措施。方法回顾性分析34例青年AMI患者和同期40例中老年(≥45岁)AMI患者的临床资料,对两组危险因素、诱因、心脏超声检查结果及冠状动脉病变特点等进行对比分析。结果青年组以男性为主,且男性所占百分数明显高于老年组[85.3%(29/34)vs.60.0%(24/40),P<0.05],大量吸烟史患者百分数明显高于老年组[82.3%(28/34)vs.45.0%(18/40),P<0.05],起病时呈典型胸痛症状患者百分数明显高于老年组[88.2%(30/34)vs.50.0%(20/40),P<0.05];青年组AMI后心脏超声下左心室扩大、射血分数降低患者百分数明显低于老年组[70.6%(24/34)vs.35.0%(14/40),P<0.05;64.7%(22/34)vs.35.0%(14/40),P<0.05],左心室短轴切面室壁节段性变薄患者百分数明显高于老年组[52.9%(18/34)vs.15.0%(6/40),P<0.05];青年组表现为ST段抬高型心肌梗死的患者百分数高于老年组[76.5%(26/34)vs.40.0%(16/40),P<0.05],冠状动脉单支病变患者百分数明显高于老年组[88.2%(30/34)vs.25.0%(10/40),P<0.05]。结论青年AMI患者以男性为主,吸烟为其主要危险因素,症状典型,病变以单支病变为主,心肌受损程度较小,预后较好。

Objectives To explore causes and prevention measurements in young aduh patients （aged 〈 45 years） with acute myocardial infarction （AMI） through analyzing clinical characteristics of them. Methods We retrospectively analyzed the clinical data of 34 young patients with AMI （youg patients group）and 40 old patients with AMI （old patients group）. Electrocardiogram （ECG） results, risk factors, inducing factors, clinical manifestation and coronary artery lesion features were compared between the two groups. Results There were mostly male patients in young patients group, and percentage of male patients was significently higher in young patients group than in old patients group [ 85.3% （29/34） vs. 60.0% （24/40）,P〈0.05 ]. Percentage of smoking patients in young patients group was significently higher than that in old patients group [82.3% （28/34） vs. 45.0% （18/40）, P〈0.05]. Percentage of typical chest pain occurred in patients when AMI onset was significently higher in young patients group than in old patients group [88.2% （30/34） vs. 50.0% （20/40）, P〈0.05]. Percentages of left ventricular enlargement and ejection fraction decrease in young patients group were significently lower than those in old patients group [70.6% （24/34） vs. 35.0% （14/40）,P〈0.05; 64.7% （22/34） vs. 35.0% （14/40）,P〈0.05]. Most young adult AMI patients showded the front board myocardial infarction and ST-elevation-AMI, while the old ones did not show these feathnres [76.5% （26/34） vs. 40.0% （16/40）,P〈0.05]. Compared with the old ones, young adult patients usually showded single vessel lesion [ 88.2% （30/34） vs. 25.0% （10/ 40）, P〈0.05 ]. Conclusions Young adult AMI patients were mostly male, and smoking is one of the main causes. Young adult AMI patients have typical clinical symptom and usually show single vessel lesion. Myocardium damage is light and prognosis is better in young adult AMI patients.