青年急性心肌梗死发病特点分析

Characteristics of acute myocardial infarction in young patients

目的探讨青年急性心肌梗死的发病特点。方法 210例急性心肌梗死患者,依据年龄分为青年组(年龄≤44岁)62例及对照组(年龄>44岁)148例,比较2组一般资料、冠状动脉造影结果、住院并发症发生情况等。结果青年组男性占98.4%,超体质量者占64.5%,吸烟者占69.3%,单身者占35.5%,有不良生活习惯者占72.6%,发病前有明显诱因者占16.1%,合并高脂血症者占66.1%,急性ST段抬高心肌梗死者占88.7%,KillipⅠ级者占90.3%;对照组分别为72.3%、31.8%、39.9%、18.2%、55.4%、6.8%、33.8%、68.2%、62.2%,2组比较差异有统计学意义(P<0.05);青年组单支血管病变者占74.2%,高于对照组(45.9%)(P<0.01),充血性心力衰竭(6.5%)、大出血发生率(0)及病死率(0)均低于对照组(27.7%,6.8%,6.1%)(P<0.05)。结论青年急性心肌梗死患者单支血管病变多见,但住院并发症较少,吸烟、不良生活方式等可控性因素与其发生有关。

Objective To investigate the clinical characteristics of acute myocardial infarction（AMI）in the young patients.Methods A total of 210 AMI patients were divided into young group（n=62）aged 44 years or younger and control group（n=148）aged older than 44 years.The clinical data,coronary angiography results and complications were compared between two groups.Results Young group had higher proportions of male（98.4%）,over-weight（64.5%）,smoking（69.3%）,unmarried（35.5%）,bad habits of living（72.6%）,obvious precipitating factors（16.1%）,hyperlipidemia（66.1%）,acute ST-segment elevation myocardial infarction（STEMI）（88.7%）and Killip class Ⅰ at admission（90.3%）than control group（72.3%,31.8%,39.9%,18.2%,55.4%,6.8%,33.8%,68.2%,62.2%）,showing significant differences between two groups（P〈0.05）.The proportion of single-vessel lesions was higher in young group（74.2%）than that in control group（45.9%）（P〈0.01）,and the incidences of congestive heart failure（6.5%）,massive haemorrhage（0）and fatality（0）were lower in young group than those in control group（27.7%,6.8%,6.1%）（P〈0.01）.Conclusion The single-vessel lesion is commonly found in young AMI patients,but the complications are less.Smoking,bad habits of living and other controllable factors are associated with the development of AMI in young patients.