血脂异常对青年男性心肌梗死患者早、中期预后的影响

目的观察青年男性急性心肌梗死（acute myocardial infarction, AMI ）患者的临床特点及血脂异常对其1年内再发心血管事件的影响。方法以50例≤45岁的青年男性AMI患者作为青年组，按电脑随机数字表法抽取同期住院50例≥65岁的老年男性AMI患者作为老年组。观察两组临床特点，出院后第3、6、9、12个月复查血脂，随访1年内再发主要心血管事件及血脂浓度，并进行比较分析。结果青年组血脂异常检出率高于老年组[28％（14／50）讯8％（4／50），P〈0．01]。青年组血脂浓度高于老年组（P〈0．05），以血清甘油三酯浓度升高为主。青年组血清甘油三酯浓度高于老年组，差异有统计学意义[（170．384±101．12）mg／dL强（118．56±60．18）mg／dL，P〈0．011。药物调脂治疗后复查，青年组血清甘油三酯浓度降低最为显著，下降水平明显低于老年组，差异有统计学意义（42％慨12％，P〈0．05）。青年组1年内再发主要心血管事件发生率低于老年组，差异有统计学意义[36％（18／50）眠60％（30／50），P〈0．05]。青年组心肌梗死后再发主要心血管事件时的血清三酰甘油浓度较入院时明显升高，差异有统计学意义[（175．07±94．79）mg／dL帆（115．19±61．22）rag／dL，P〈0．05]。结论（1）青年男性AMI患者的血脂水平高于老年组，其血脂异常以高三酰甘油为主。（2）调脂治疗后青年男性AMI患者1年内心血管事件的再发生率低于老年组，其血脂下降水平也明显低于老年组。（3）青年男性AMI患者随着血清三酰甘油浓度的升高再发主要心血管事件增加。

Effect of dyslipidemia on the short, mid-term prognosis in young male patients with acute myocardial infarction

Objectives To observe the clinical characteristics in young male patients with acute myocardial infarction(AMI) and investigate the effect of dyslipidemia their on their recurrent cardiovascular events in 1 year.Methods A total of 50 young male patients(≤45 years old) with AMI were enrolled as youth group.Another 50 elderly male(≥65 years)patients with AMI hospitalized during the same period were randomly selected as elderly group.Clinical characteristics were observed and recorded in all patients.Lipid level were measured at the 3th,6th,9th,12th month after their discharge and recurrent cardiovascular events(angina,heart failure,reinfarction,cardiac death) were followed up for 1 year.Results Prevalence of dyslipidemia in youth group was significantly higher than that in elderly group [28%(14/50) vs.8%(4/50),P<0.01].Blood lipid levels in youth group were significantly higher than those in elderly group(P<0.05),in which triglyceride(TG) concentration mainly incleased.Serum concentration of TG in youth group was significantly higher than that in elderly group [(170.38± 101.12)mg/dL vs.(118.56±60.18) mg/dL,P<0.01].After statin treatment,serum concentration of TG was significantly decreased in youth group,which was much lower than that in elderly group(42% vs.12%,P<0.05).Eighteen of 50 young AMI patients(36%) were recorded as recurrent adverse cardiovascular events within 1 year,which was significantly lower than that in elderly group(30/50,60%,P<0.05).The serum concentration in youth group when reccurrent cardiovascular events occurred was significantly higher than hospitalized [(175.07±94.79) mg/dL vs.(115.19±61.22) mg/dL,P<0.05].Conclusions(1) Serum lipid level in young male patients with AMI is higher than that in elderly AMI patients;Dyslipidemia in young male patients with AMI is mainly hypertriglyceridemia.(2) After lipid lowering treatment,the rate of recurrent cardiovascular events within one year in young AMI males is smaller than that in the elderly;In addition,the blood lipid level is also significantly lower than that in the elderly.(3) Dyslipidemia especially hypertriglyceridemia in young male AMI patients has more effects on recurrent cardiovascular events.What’s more,with the increase of serum concentration of TG,the rate of recurrent cardiovascular events is also increased.