57例青年急性心肌梗死危险因素及临床特点分析

The Clinical Features and Risk Factors Analysis of 57 Cases of Acute Myocardial Infarction in Young Adults

目的探讨青年急性心肌梗死(AMI)的临床特点及相关危险因素。方法对2008年10月至2012年10月在双流县中医医院就诊的117例AMI患者的临床资料和临床表现进行回顾性分析,依据患者年龄分为青年组(年龄≤45岁)和老年组(年龄≥60岁),探讨青年AMI的危险因素。结果青年组AMI患者的男女性别比与老年组比较,差异有统计学意义(χ2=9.357,P<0.05);青年组患者抽烟、酗酒以及具有心血管疾病家族史者的人数显著多于老年组(χ2=8.271,3.877,7.356,P<0.05),而糖尿病和高血压患者的人数显著少于老年组(χ2=8.749,3.906,P<0.05)。青年AMI患者发病时发生心绞痛的人数较老年患者少,发生典型胸痛者较老年组多;青年AMI患者发生心律失常、心力衰竭以及心源性休克的人数均少于老年患者;两组患者心肌梗死发生部位比较差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示:吸烟史、酗酒史、糖尿病以及有心血管疾病家族史是青年AMI的危险因素(P<0.05)。结论青年AMI发病与老年患者有明显不同,吸烟、酗酒以及有心血管疾病家族史等是青年AMI患者的高危因素。戒烟、限酒、养成良好的生活习惯对预防青年人AMI有重要意义。

Objective To investigate the clinical characteristics and risk factors for the acute myocardial infarction （AMI） in young adults.Methods The clinical data of 57 young patients （≤45 years）with AMI admitted to Shuangliu County Hospital of Traditional Chinese Medicine from Oct.2008 to Oct.2012 were retrospectively analyzed,and 60 cases of aged patients（≥60 years）with AMI admitted to the hospital during the same period were included as the control.Then,the risk factors and the clinical manifestations of the two groups were explored.Results Comparing the sex ratio of young AMI patients with the elderly group,the difference was statistically significant（x2 =9.357,P 〈 0.05）,the numbers of patients with smoking,binge drinking and family history of cardiovascular disease in young group were significantly more than the elderly group（x2 =8.271,3.877,7.356,P 〈 0.05）,while the numbers of patients with diabetes mellitus and hypertension were significantly less than the elderly group （x2 =8.749,3.906,P 〈 0.05）.The nunber of young AMI patients with angina occurring was less than elderly patients,while the typical chest angina was more than the elderly group.The young AMI patients with arrhythmia,heart failure and cardiogenic shock in were less than the elderly patients ; the myocardial infarction position had statistically significant difference between the two groups（P 〈 0.05）.Conclusion The onset of AMI disease in the elderly patients and young patients is significantly different,smoking,drinking and family history of cardiovascular disease are risk factors for young AMI patients.Quitting smoking,limiting alcohol intake and developing good life habits are important for youth to prevent AMI.