对50岁以下急性冠脉综合征的临床特点的初步探讨

The study on the clinical features of acute coronary syndrome in patients younger than 50 years of age

目的：评价50岁以下急性冠脉综合征的临床特征及其与老年人群息性冠脉综合征的差异。方法：回顾性分析我院2007年至2011年出院诊断为急性冠脉综合征的患者的危险因素、冠脉造影结果、治疗、预后。结果：50岁以下急性冠脉综合征患者共60例（中青年组），除1例女性外均为男性；年龄分布为34—49岁，其中8例≤40岁。60岁以上急性冠脉综合征患者共584例（老年组），年龄分布为60—82岁，男性391例，女性193例。与老年组比较，中青年组有更高的吸烟率（86．7％VS57．8％）和阳性心血管病家族史30％VS：15．1％），较低的血脂异常率（33．3％vs46．7％），糖尿病（5％vs26．4％）和高血压（10％vs62．5％）。中青年组的0—1支冠脉病变（72．4％vs40．2％）及ST抬高的心肌梗塞更多见（66．7％vs24．8％）。此外，接受冠脉介入诊疗率（96．7％vs60．4％）和左室射血分数（52．4±12．1vs39．8±14．6）显著高于老年组；中青年组N末端B型利钠肽原（NT—proBNP）水平和住院期间死亡率（4．11％VS0％）显著低于老年组。结论：①吸烟是50岁以下急性冠脉综合征患者最重要的危险因素；②与老年组比较，50岁以下急性冠脉综舍征患者更易于接受冠脉介入诊疗；心功能和预后相对良好。

Objective： To evaluate the features of acute coronary syndrome （ACS） in patients younger than 50years old and the difference between young aduh and more than 60 years old. Methods：This is a retrospective study of risk factors, results of coronary angiography,theraphy and prognosis of patients with a diagnosis of ACS between 2006 and 2011. Results：Compared with the Old group,the Young group had lower incidences of hyperten-sion （p〈 0.01） ,diabetes mellitus （p 〈 0.01） and hyperlipidemia （p〈0.05） ,a higher incidence of smoking and positive family history （p〈0. 01）, Also,the Young group had a higher prevalence of 0-1 vessel disease and ST-elevation AMI than the Old group, There is a better lest ventricu- lar function and lower mortality in the period of hospitalization in the young group. Conclusion：①Smoking is the most important and prevalent risk factor in the young group;②There is a higher prevalence of underwent PCI and better prognosis in the Young group.