青年急性心肌梗死的特点和预后分析

目的探讨青年急性心肌梗死(AMI)患者的临床特点及预后。方法回顾性分析2013年1月至2018年12月AMI患者的临床资料,分为青年组(年龄≤40岁)201例,老年组(年龄≥60岁)201例。比较两组患者的临床特点及预后情况。结果吸烟、早发冠心病家族史等是青年AMI发病的危险因素(P<0.05),老年组糖尿病、高血压所占比例明显偏高(P<0.05);青年组患者生存率在住院期间(199,99.0%vs.184,91.5%,P<0.001),术后6个月(195,97.0%vs.178,88.6%,P=0.001),长期随访[平均(38.6±20.5)个月](188,93.5%vs.168,83.2%,P=0.002)均高于老年组。进行多因素回归分析时,调整各因素后仍保留青年患者的生存优势[HR=0.452(95%CI:0.208~0.978,P=0.044)]。结论青年AMI自身危险因素有一定特殊性,可以针对性进行一级预防,但青年AMI患者的预后一般优于老年患者。

Objective The incidence of myocardial infarction in youth is getting higher.It has different clinical characteristics.There is not much research on the prognosis of myocardial infarction in Chinese youth.To explore the different clinical characteristics and the prognosis of young and elderly patients with acute myocardial infarction(AMI).Methods 201 young patients(≤40 years)and 201 elderly patients(≥60years)with AMI from January 2013 to December 2018 were included.The different clinical characteristics and the prognosis were compared and analyzed between the two groups.Results Smoking and a family history of premature coronary heart disease were more frequent in young patients(P<0.05).Hypertension and diabetes were more frequent in older patients(P<0.05).After an average follow-up of(38.6±20.5)months,whether during hospitalization(199,99.0%vs.184,91.5%,P<0.001),6 months after surgery(195,97.0%vs.178,88.6%,P=0.001)or long-term follow-up(188,93.5%vs.168,83.2%,P=0.002),the survival rate of the young patients with AMI was higher than that of the elderly.When multivariate analysis was applied to the data,the survival advantage for young patients remained after adjustment[HR=0.452(95%CI:0.208~0.978,P=0.044)].Conclusions Young patients with AMI have different clinical characteristics and a favorable prognosis compared with that in older patients.