40岁以下青年急性心肌梗死患者冠状动脉病变及临床特点

摘要

Objective: To investigate the clinical characteristics and features of coronary artery disease of ≤40 years old young patients with acute myocardial infarction (AMI). Methods: A total of 415 patients of our hospital were definitely diagnosed as AMI through primary or delayed percutaneous coronary intervention from January 2007 to December 2010, in which 126 patients with age ≤50 years old, and they were divided into two groups according age: young group (n=29, age ≤40 years old); middle-aged group (n=97, 40 years＜age≤50 years old). Clinical characteristics and features of coronary artery disease of the two groups were retrospectively analyzed and followed up for three months. Results: There were more heavy smokers (20 cigarettes/d, ＞10 years) in young group than that of middle— aged group (55. 2％ vs. 30. 9％) s patients complicated diabetes and hypertension in young group were significantly fewer than those of middle-aged group (diabetes: 3. 4％ vs. 23. 7％, hypertension: 27. 6％ vs. 41. 2％) , cases complicated dyslipidemia in young group was significantly more than that of middle-aged group (58. 6％ vs. 36. 1％) . Distributive characteristics of infarct-related artery showed no significant difference between the two groups (P＞0. 05); but patients with single-vessel coronary disease in young group were significantly more than that of middle-aged group (72. 4％ vs. 43. 3％) . No one died in young group and two cases died in middle-aged group during admission. Conclusion: Heavy smoking and dyslipidemia are the main risk causes for AMI patients aged 40 years old or younger. In these patients. there are relatively few cases complicated diabetes and hypertension, more single-vessel coronary disease and short-term prognosis is good.%目的:探讨40岁以下青年急性心肌梗死(AMI)患者的冠状动脉病变特征及临床特点.方法:2007年1月至2010年12月我院经急诊或择期冠状动脉介入诊疗明确诊断的AMI患者共415例,其中年龄≤50岁的中青年患者126例,按年龄分为两组:青年组(29例),年龄≤40岁;中年组(97例),40岁<年龄≤50岁.对两组冠状动脉病变特征及临床特点进行回顾性分析,所有病例随访3个月.结果:青年组大量吸烟者(20支/d,10年以上)显著多于中年组(55.2%比30.9%);合并糖尿病和高血压者显著少于中年组(3.4%比23.7%,27.6%比41.2%),合并血脂异常者显著多于中年组(58.6%比36.1%).梗死相关血管分布特点两组间无显著差异(P>0.05);但冠状动脉单支病变者青年组显著多于中年组(72.4%比43.3%).住院期间青年组无一例死亡,中年组死亡两例.结论:大量吸烟和血脂异常为40岁以下青年急性心肌梗死患者的主要发病因素,合并糖尿病及高血压者相对少见,单支血管病变多见,住院期死亡率低,短期预后好.