年轻急性心肌梗死患者的临床特征

为探讨年轻患者急性心肌梗死 (AMI)的临床及冠状动脉特点 ,对 40岁以下男性 2 7例和绝经前女性 2 4例 ,共 5 1例急性心肌梗死 (AMI)患者的病史、动脉硬化相关危险因素、冠状动脉造影及预后进行分析。结果显示 ,女性组危险因素平均 2 .3个 ,按发生率高低分别为 :阳性家族史 1 9例 (79.2 % ) ,高胆固醇血症 1 2例 (5 0 .0 % ) ,高血压 1 0例 (4 1 .7% ) ,糖尿病 8例 (3 3 .3 % ) ,吸烟史 1例 (4 .2 % )。男性组危险因素平均 3 .1个 ,按发生率高低分别为 :吸烟史2 6例 (96.3 % ) ,高胆固醇血症 1 9例 (70 .4% ) ,阳性家族史 1 7例 (63 .0 % ) ,高血压 1 4例 (5 1 .9% ) ,糖尿病 7例(2 5 .9% )。冠状动脉造影结果显示 ,男性以单支病变为主 ,共 1 4例 ,占 5 1 .9% ,女性以多支病变为主 ,共 1 4例 ,占5 8.3 %。提示冠状动脉粥样硬化仍然是年轻男性和绝经前女性心肌梗死的主要原因 ,多个危险因素是年轻患者共同的特点 ,危险因素中女性以阳性家族史为首 ,男性则以吸烟史为首。

Clinical Characteristics of Acute Myocardial Infarction in Young Men

The aim was to investigate the coronary angiographic findings and clinical features of acute myocardial infarction(AMI) patients in premenopausal women and young men. Altogether 51 AMI patients(27 men, age<40 years old; 24 premenopausal women) were identified by coronary angiography to analysis their disease history, cardiovascular risk factors, angiographic data and prognosis. The mean risk factors was 2.3 in women, including: family history 19( 79.2%), hypercholesterolemia 12( 50.0%), hypertension 10(41.7%), diabetes 8(33.3%), smoking 1(4.2%). The mean risk factors was 3.1 in men, which were: smoking 26(96.3%), hypercholesterolemia 19(70.4%),family history 17(63.0%), hypertension 14( 51.9%),diabetes 7(25.9%). Angiographic findings reveals: one-vessel disease was 51.9% in men, multi-vessel disease was 58.3% in women. The rates of angiographic therapy success was similar in the men and women and were excellent. Angiographic follow-up: 4 in men developed restenosis, none in women. The results suggest coronary artery atherosclerosis is the major cause of AMI in young men and premenopausal women. The more frequency of multiple risk factors is the characteristic of young AMI patients, and family history lies in the first in women, smoking is a marked risk factor in men.