青年急性心肌梗死患者危险因素及冠状动脉病变特点分析

Risk factors and characteristics of coronary angiography in young patients with acute myocardial infarction

目的探讨青年急性心肌梗死(AMI)患者的危险因素及冠状动脉病变特点。方法纳入2008年1月至2012年6月期间解放军总医院心血管研究所青年(≤45岁)AMI患者150例,作为青年AMI组;纳入同期45岁以上AMI患者160例,作为老年AMI组,比较两组患者的临床特征和冠状动脉造影结果。结果与老年AMI组相比,青年AMI患者男性比例和吸烟比例较高(分别为:96.0%vs.75.6%和62.7%vs.35.6%),高血压和高脂血症比例较低(分别为37.3%vs.49.4%和40.0%vs.66.9%),差异有统计学意义(P<0.05);通过对132例青年AMI的冠脉造影结果进行分析(占50.0%),有8例(6.1%)未见明显冠脉狭窄,以单支病变为主;老年组则以多支病变为主(占74.8%)。结论与老年AMI相比,青年AMI患者合并症发生率较低,但吸烟比例较高,同时青年AMI患者较老年AMI的病变累及冠脉少,多以单支病变为主。

Objective To discuss the risk factors and characteristics of coronary artery lesions in young patients with acute myocardial infarction （ AMI ） . Methods The young patients with AMI （ aged≤45, n=150 ） were chosen as young AMI group, and other 160 patients （ aged over 45 ） were chosen as elderly AMI group from the Institute of Geriatric Cardiovascular Diseases of Chinese PLA General Hospital from Jan. 2008 to Jun. 2012. The clinical features and results of coronary angiography （ CAG ） were compared between two groups. Results Compared with elderly AMI group, the proportion of male cases and smoking cases were higher （ 96.0% vs. 75.6% and 62.7% vs. 35.6% ） , the proportion of hypertensive cases and hyperlipidemia cases were lower （ 37.3% vs. 49.4% and 40.0% vs. 66.9%, P〈0.05 ） in young AMI group. After the analysis on the results of CAG in 132 young patients, there were 8 cases （ 6.1% ） without obvious coronary stenosis and coronary artei7 lesions were mainly single vessel lesion （ 50% ） , while in elderly AMI group, coronary artery lesions were mainly multiple vessel lesion （ 74.8% ） . Conclusion Young patients with AMI have lower incidence of complications but higher smoking proportion compared with elderly ones. The numbers of lesion vessels involved by AMI are less, and coronary artery lesions are mainly single vessel lesion in young patients.