青年人急性心肌梗死的临床和冠状动脉造影特点分析

目的分析青年人急性心肌梗死的临床特点及冠状动脉造影特点,探讨如何预防青年人急性心肌梗死。方法对36例年龄<45岁急性心肌梗死患者和年龄>65岁急性心肌梗死患者进行对比观察,从性别、危险因素、临床特点、冠状动脉病变程度、并发症及预后等方面进行比较。结果青年人急性心肌梗死以男性多见,为34例(94.4%),高脂血症19例(52.8%),发病前有明确的诱因26例(72.2%),典型的胸痛33例(91.7%),右心室和下壁心肌梗死10例(27.7%),ST段抬高型心肌梗死31例(86.1%),均明显高于老年组;冠状动脉造影病变血管以右冠状血管多见,以单支病变为主,很少累及主干,两组相比差异显著(P<0.01);并发症、心功能衰竭、肺部感染明显低于老年组(P<0.01)。结论青年人急性心肌梗死男性多见,有明确的危险因素和诱发因素,症状典型,以单支病变为主,并发症少,早期介入治疗预后好;规范青年人冠心病的二级预防,可防止青年人急性心肌梗死过早发生。

Clinical Features and Coronary Angiographic Features in Young Patients with Acute Myocardial Infarction

Aim To analyze the features of the clinical and the coronary angiography in young patients with acute myocardial infarction(AMI)and prevent young people from the earlier occurrence of AMI. Methods 36 young patients(<45 years old) were compared with 40 older patients(>65 years old)from the sex,risk factors,clinical characters,coronary lesion levels,complications and prognosis. Results Most young patients with AMI were men(94.4%). Among them,there were 19(52.8%) patients had hyperlipidemia,26(72.2%)patients had inducement, 33(91.7%)patients had intense chest pains,10(27.7%) patients were interior myocardial infarction and right ventricular infarction,and 31(86.1%) patients had single vessel disease,each of which was higher than the old group.Coronary angiogram revealed that most vessels disease was right coronary atrial,and mainly were single vessel disease,while rarely main coronary artery.These results showed significant difference in the two groups(P<0.01).The complications of young group such as heart failure and pulmonary infection were obviously less than that of the old group(P<0.01). Conclusion The young patients with AMI are mostly man.Most of them,with typical symptom,less complication and good prognosis,had induced factors and risk factors,and most of their vessel diease is single vessel.So an early invasive strategy with percutaneous coronary intervention(PCI) is better for prognosis,and standard secondary prevention can prevent the earlier occurrence of coronary heart disease in young patients.