青年急性心肌梗死患者血尿酸、血脂及冠脉病变特点

Blood uric acid,blood lipids and coronary angiographic characteristics in young patients with acute myocardial infarction

目的:探讨40岁以下急性心肌梗死(AMI)患者血尿酸、血脂及冠状动脉病变特点。方法:回顾分析2007年12月～2010年12月就诊于北京友谊医院,并确诊为AMI的40岁及以下患者(青年组)42例,与40岁以上的AMI患者380例(中老年组)进行对照研究,分析其血尿酸、血脂等危险因素以及冠脉病变程度的不同特点。结果:青年组患者血尿酸水平、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、体质量指数(BMI)、男性及吸烟者比例显著高于中老年患者,具有统计学差异;冠脉造影显示青年组单支血管病变明显多于老年组,而双支与多支病变则显著少于中老年组。通过多元相关分析,AMI患者血尿酸与性别、BMI、TG、糖化血红蛋白(HbA1c)相关,与年龄无明显相关。消除BMI、TG、HbA1c影响,两组患者血尿酸仍有统计学差异。结论:与中老年组比较,青年组AMI患者血尿酸水平、脂代谢异常及BMI明显升高,冠脉病变以单支血管病变较常见;男性患者为主。

AIM：To explore blood uric acid,blood lipids and coronary angiographic features in young patients with acute myocardial infarction（AMI）.METHODS： Data were collected and analyzed retrospectively in 42 patients（≤40 years of age） in the young group（YG） and 380 patients（40 years of age） in the elder group（EG）.Patients in both groups were diagnosed as having AMI and were treated at the Beijing Friendship Hospital from December 2007 to December 2010.RESULTS： Levels of blood uric acid（UA）,triglycerides（TG） and low-density lipoprotein-cholesterol（LDL-C）,body mass index（BMI）,proportion of males and smokers in YG were significantly higher than those in EG.Coronary angiography showed that the incidence of one-vessel lesion in the YG was higher than that in EG（52.4% vs.10.8%,P0.01）,but the incidence of double-and multivessel lesions in the YG was lower than that in the EG（23.8% vs.41.3%;21.4% vs.47.9%,P0.01）.Multiple regression analysis showed a significant positive correlation between UA and gender,BMI,TG and glycosylated hemoglobin（HbA1c）,respectively.After eliminating the influence of BMI,TG and HbA1c on the results,a significant difference in the level of blood UA was also observed between groups.CONCLUSION： The majority of young AMI patients（≤40 years） are male.The level of blood UA in young patients is higher than that in older patients.Metabolic disorders and smoking are the major risk factors for AMI prior to the age of 40 years.Young AMI patients often have milder coronary artery stenosis than elderly AMI patients.