中青年人急性心肌梗死临床特点及直接经皮冠状动脉腔内成形术特征分析

Clinical Characteristics and PCI Features of Young and Middle-aged AMI Patients

目的探讨45岁以下中青年急性心肌梗死患者临床特点及直接经皮冠状动脉内成形术的特征。方法回顾性分析本院近5年来55例中青年急性心肌梗死患者的临床特征及冠状动脉腔内成形术的特征。结果中青年急性心肌梗死诱因明显、起病急骤、症状典型且并发症少,合并高脂血症、高血压、糖尿病等基础疾病的比例分别为45.45%(25/55)、32.73%(18/55)和23.64%(13/55),冠状动脉单支、双支、三支病变的比例分别为52.73%(29/55)、30.91%(17/55)和16.36%(9/55),罪犯血管大部分为前降支(61.67%),冠状动脉闭塞发生率达35.00%,血栓形成率为14.55%。冠状动脉均无钙化,钢丝一次性通过率、开通成功率为98.18%(54/55),无一例发生PCI并发症,随访3个月无严重不良心血管事件发生。结论中青年急性心肌梗死有一定的诱因和发病临床特点,可针对性进行一级预防,减少发病率;中青年急性心肌梗死患者直接冠状动脉介入治疗开通血管成功率高,预后较好。

Objective To determine the clinical characteristics and PCI（percutaneous coronary intervention） features of young and middle-aged AMI（acute myocardial infarction） patients under 45 years old.Methods The clinical data and PCI features of 55 young and middle-aged（≤45 years old）AMI patients during latest 5 years were retrospectively analyzed.Results（1）The clinical characteristics of the 55 young and middle-aged AMI patients included notable predisposing cause,acute onset,typical symptoms and less complications.（2） 45.45%（25/55）had hyperlipoidemia,32.73%（18/55）had hypertension,23.64%（13/55）had diabetes at the same time.（3） PCI features：The proportion of single vessel coronary disease,double vessel disease,three lesions was 52.73%（29/55）,30.91%（17/55）,16.36%（9/55）respectively.LAD（Left anterior descending artery） was most common among criminals（61.67%）,35.00% had coronary occlusion and the incidence of coronary thrombus was 14.55%.The wire passed the lesions successfully in the first-time try in 98.18% cases.No calcification and PCI complication.No major adverse coronary events during the following 3-month follow-up.Conclusion AMI of young and middle-aged under 45 has its special causes and clinical characteristics and could be prevented by primary prevention strategies.PCI therapy can acquire a high revascularization rate and bring favorable prognosis for these people.