早发心肌梗死患者的临床特点和冠状动脉特点

The clinical and coronary angiography characteristics in patients with premature myocardial infarction

目的研究早发心肌梗死患者的临床特点和冠状动脉病变特点。方法收集早发ST段抬高型心肌梗死患者(早发组)159例,非早发ST段抬高型心肌梗死患者(非早发组)190例,比较2组一般资料、实验室检查结果、冠状动脉造影结果及院内并发症发生情况。结果早发组男性比例、BMI水平、吸烟比例、早发冠心病家族史比例、高脂血症比例、入院舒张压水平、心功能Killip分级2级以上比例高于非早发组,高血压、糖尿病、脑卒中、肾脏疾病和贫血比例均低于非早发组;早发组LDL-C、总胆固醇、三酰甘油、非HDL-C水平均高于非早发组;早发组血红蛋白水平高于非早发组,血肌酐、血糖水平均低于非早发组;早发组住院期间接受冠状动脉造影和急诊PCI比例均高于非早发组,早发组梗死相关血管以左前降支最常见,比例高于非早发组;受累冠状动脉单支病变比例高于非早发组,病变部位以左主干和右冠状动脉受累在非早发组中更多见;早发组院内严重并发症发生率和院内病死率低于非早发组。结论早发心肌梗死患者的男性、吸烟、早发冠心病家族史比例,BMI水平、血脂水平均高于非早发心肌梗死患者;早发心肌梗死患者梗死相关血管以前降支最常见,院内严重并发症及病死率均低于非早发心肌梗死患者。

Objective To explore the clinical and coronary angiography features in patients with premature myocardial infarction(pMI). Methods One hundred and fifty-nine patients with premature ST-segment elevation myocardial infarction(pMI group) and 190 patients with non-premature ST-segment elevation myocardial infarction(non-pMI group) were collected.General data,laboratory examination results,coronary angiography results and hospital complications of the two groups were compared. Results In the pMI group,the proportion of males,BMI,smoking,family history of early-onset coronary heart disease,hyperlipidemia,diastolic blood pressure on admission,and cardiac function grade 2 or above was higher than that in the non-pMI group.In the pMI group,the proportion of hypertension,diabetes,stroke,kidney disease and anemia was lower than that in the non-pMI group.The levels of LDL-C,total cholesterol,triglyceride and non-HDL-C in the pMI group were all higher than those in the non-pMI group.The hemoglobin level in the pMI group was higher than that in the non-pMI group,and the serum creatinine and blood glucose levels were lower than that in the non-pMI group.The proportion of patients in the pMI group receiving coronary angiography and emergency PCI during hospitalization was higher than that in the non-pMI group.The left anterior descending artery was the most common infarct-related vessel in the pMI group,which was higher than that in the non-pMI group.The proportion of single coronary artery involvement was higher in the pMI group.In the lesion site,the involvement of left main artery and right coronary artery was higher in the non-pMI group.The incidence of serious complications and mortality in the pMI group were lower than those in the non-pMI group. Conclusion The proportion of male,smoking,family history of early onset coronary heart disease,BMI and blood lipid levels of the patients with pMI were all higher than the non-pMI patients.Left anterior descending arterys were the most common infarct-related vasculars in pMI patients.The serious complications and mortality in hospital in pMI patients were lower than those in non-pMI patients.