非高血压及糖尿病急性心肌梗死患者的危险因素及冠状动脉病变特点分析

目的探讨无高血压及（或）糖尿病的初发急性心肌梗死（AMI）患者的危险因素及冠状动脉病变特点。方法选择AMI且无高血压及糖尿病的患者170例，按年龄分为青年组23例（年龄〈45岁），中年组69例（45岁≥年龄〈60岁），老年组49例（60≥年龄〈75岁）和高龄组29例（年龄≥75）。分析各组患者AMI的危险因素及冠状动脉病变特点。结果高龄组中，女性患者比例明显升高，与其他3组比较差异有统计学意义（P〈0．05）。青、中、老年组吸烟史比例明显高于高龄组（P〈0．05）。各组发病诱因及饮酒史比例差异无统计学意义。青、中年组身体质量指数（BMI）明显高于老年组及高龄组（P〈0．05）。青、中年组TC、TG及LDL．C水平均显著高于老年组及高龄组（P〈0．05）。各组HDL-C和UA、病变血管及冠状动脉病变差异无统计学意义。结论无高血压及（或）糖尿病的急性心肌梗死患者中，性别、吸烟、家族史、高血脂血症等是冠心病的危险因素，而年龄、尿酸、HDL—C对冠状动脉病变无明显影响，不同年龄组冠状动脉病变情况未见明显差异；因此，应重新审视年龄、尿酸等危险因素在非高血压及（或）糖尿病的AMI中的作用（尤其在年轻人中），针对处理不同年龄组的主冠心病危险因素。

Objective To observe the risk factors and coronary arterial lesion characteristics in different age groups of patients with acute myocardial infarction （ AMI ） , excluding hypertension and Diabetes. Methods The risk factors and the data of coronary angiography in 170 patients with AMI excluding heart disease and Diabetes who were divided into four groups （ young, middle age, aged and senile group ） were analyzed retrospectively. Results The ratio of female patients in senile group increased significantly compared with young group, middle age group and aged group （ P〈0.00835 ） .The ratio of smoking in young group, middle age group and aged group was higher than senile group（P〈0.05）. No statistical significance difference in each group was found in the proportion of predisposing factors and drinking history. The BMI of Young and middle-aged group was significantly higher than the elderly and senile group （ P〈0.05 ） .The level ofTC, TG and LDL-C of young and middle-aged groups were significantly higher than that of aged group and senile group （ P〈0.05 ） .There was no statistically significant difference in HDL-C, UA levels and coronary arterial lesion characteristics among different groups. Conclusion In patients of AMI without hypertension and Diabetes, sex, smoking and hyperlipidemia is still the high risk factors of coronary heart disease. However, age,VA and HDL-C had no obvious effect on coronary artery lesions in these patients, there was no significant difference of coronary arterial lesion in different groups. Therefore, we should review the risk factors including age, uric acid in hypertension and （ or ） the role of diabetes of AMI, especially young people, and primarily deal with the main risk factors of coronary heart disease in different age groups.