青年急性ST段抬高心肌梗死患者冠状动脉造影及血管内超声特点分析及护理

Characteristics of coronary angiography and intravascular ultrasound in young patients with acute ST-segment elevation myocardial infarction and Clinical Care

目的探讨分析青年急性ST段抬高型心肌梗死(STEMI)的高危因素、冠状动脉造影及血管内超声影像特征。方法选取年龄≤45岁的青年急性心肌梗死患者20例(A组)和同期年龄>50岁的中老年急性心肌梗死患者61例(B组)进行对比观察,从高危因素、冠状动脉造影及血管内超声影像特征等方面进行比较。结果与B组中老年STEMI患者相比,A组青年STEMI患者吸烟比例更高,体重指数、低密度脂蛋白-c及脂蛋白磷脂酶A2较B组显著增高,差异具有统计学意义(P<0.05)。A组青年STEMI患者单支病变发生率显著高于B组中老年STEMI患者,三支病变发生率较B组显著降低,A组青年STEMI患者血管内超声显示以脂质斑块为主,斑块破裂更常见,差异有统计学意义(P<0.05)。结论吸烟、肥胖及低密度脂蛋白-c、及脂蛋白磷脂酶A2是青年STEMI患者的最重要的危险因素,青年STEMI患者冠状动脉病变大部分为单支血管病变,以脂质斑块为主,斑块破裂常见。

Objective To analyze the characteristics of coronary angiography and intravascular ultrasound imaging of acute ST-segment elevation myocardial infarction in young people,and to explore how to prevent and treat acute myocardial infarction in young people and reduce the disability rate.Methods 20 young patients aged≤45 years with acute myocardial infarction(group A)and 61 elderly male patients aged>50 years with acute myocardial infarction(group B)were compared from the aspects of risk factors,clinical features,coronary angiography and intravascular ultrasound imaging characteristics.Results Patients in group A had smoking history(P<0.05)and high body mass index(P<0.05),low density lipoprotein and lipoprotein phospholipase A2 were significantly higher than those in group B,the difference was statistically significant(P<0.05).The incidence of single vessel lesions in group A was significantly higher than that in group B,and the lipid plaques were dominant,and the plaque rupture was more likely to occur.The incidence of three vessel lesions was significantly lower than that of group B(P<0.05).Conclusion Smoking,obesity,low density lipoprotein-C and lipoprotein-phospholipase A2 are the most important risk factors for STEMI in young adults.Most coronary artery lesions are single-vessel lesions dominated by lipid plaques and common plaque rupture.