不吸烟中青年AMI的危险因素及冠状动脉病变特征

摘要

目的 探讨不吸烟的中青年急性心肌梗死(AMI)的危险因素及冠状动脉(简称冠脉)病变特征.方法 收集在我院住院诊断为AMI并行冠状动脉造影,且无吸烟史的146例中青年(年龄≤50岁)患者的临床资料,并进行回顾性分析;选取同时期住院行冠脉造影或冠脉CTA排除冠心病诊断的无吸烟史中青年120例作为正常对照组,观察体重指数(BMI)、血红蛋白、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、高血压(EH)、2型糖尿病、不良生活方式及早发冠心病家族史等与AMI及冠脉病变的关系.结果 ①与正常对照组相比,不吸烟中青年AMI组合并高血压、糖尿病较多(P均<0.05),具有更高水平的BMI、TG、LDL-C(P均<0.05);②Logistic回归分析显示,与不吸烟中青年AMI独立相关的危险因素依次为LDL-C(OR=6.083)、TG(OR=3.185)、高血压(OR=2.129)及BMI(OR=1.119)(P均<0.05);③研究结果示,不吸烟中青年AMI患者以ST段抬高型心肌梗死为主.进一步冠脉造影结果显示,单支病变86例,其中左前降支病变43例,右冠状动脉病变31例.结论 LDL-C、TG、高血压及BMI是不吸烟中青年AMI患者主要的危险因素.不吸烟中青年AMI患者以冠脉单支病变多见.%Objective To observe the risk factors and coronary angiographic features of non-smoking young and middle-aged patients with acute myocardial infarction (AMI).Methods A total of 146 non-smoking young and middle-aged patients (≤50 years old) who were diagnosed with AMI and underwent coronary angiography were included in the current study and their clinical data were retrospectively analyzed.Meanwhile,another 120 non-smoking young and middle-aged patients who was not diagnosed with coronary heart disease through coronary angiography CTA were selected as a control group.The relationship between body mass index (BMI),hemoglobin,total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C),essential hypertension (EH),type 2 diabetes mellitus,unhealthy lifestyle and the family history of early coronary artery disease and AMI and the pathogenesis of the coronary artery were observed.Results Compared with the control group,the young and middle-aged patients with AMI produced higher levels of BMI,TG and LDL-C (all P<0.05).Logistic regression analysis showed that LDL-C (OR=6.083),TG (OR=3.185),EH (OR=2.129) and BMI (OR=1.119) were the independent risk factors for non-smoking young and middle-aged patients with AMI (all P<0.05).Among young and middle-aged patients with AMI,there were 132 patients with ST-segment elevation myocardial infarction,including 86 patients with single-vessel disease (43 patients with left anterior descending artery disease and 31 patients with right coronary artery disease) by coronary angiography.Conclusions LDL-C,TG,EH and BMI are the risk factors of non-smoking young and middle-aged patients with AMI.Single vessel coronary disease is the most common coronary angiographic feature of non-smoking young and middle-aged patients with AMI.