青年冠心病患者危险因素及冠状动脉病变的临床分析

目的探讨青年冠心病（CHD）患者危险因素及病变特点。方法选择冠状动脉造影确诊的青年CHD患者97例，男性94例，女性3例，回顾性分析危险因素、冠状动脉病变特点及支架置入资料。结果急诊住院42例（43．30％），急性及陈旧性心肌梗死35例（36．08％）。各危险因素阳性率依次为：吸烟78．35％，高甘油三酯血症59．79％，严重超重53．61％，高血压43．30％，高胆固醇血症27．84％，家族史22．68％，酗酒18．56％，糖尿病12．37％；具有3个以上危险因素者51例（52．58％）。冠状动脉单支病变56例（57．73％）、双支病变27例（27．84％）、三支病变14例（14．43％）。病变血管狭窄〉75％者152支，左前降支（IAD）57．89％，回旋支（LCX）13．82％，右冠状动脉（RC）27．63％，左主干（LM）0．07％。支架置入术干预血管127支，支架的大小及长度为：LAD（3．25±0．34）mm×（23．47±4．36）mm，LCX（3．01±0．32）mm×（23．27±5．87）mm，RC（3．60±0．43）mm×（26．83±4．43）mm。结论多数青年CHD患者发病突然，病变严重，约半数患者病变累及LAD。吸烟、高甘油三酯血症、严重超重、高血压等是最重要的危险因素。

Analysis of the risk factors and the coronary artery lesions of the youth patients with coronary heart disease

Objective To analyze the risk factors and the coronary artery lesions of the youth patients with coronary heart disease （CHD）. Methods 97 youth patients were identified as CHD by coronary angiography. The risk factors, coronary artery lesions and the results of steuts were analyzed. Results 43.30% patients were admitted from the emergency department and 36.1% suffered acute or old myocardial infarction. The positive perceutage of the risk factors as followed： Smoking （78.35%）, hyperlipdemia（59.79% ）, serious overweight（53.61% ） and hypertension （43.30%）. More than three risk factors was 52.58%. The single coronary artery lesions was 57.73%, two coronary artery lesions was 27.84% and three was 14.43%. The coronary arteries with stenosis over 75% were 152. The left descending artery （LAD） was 57.9%. The left circumflex artery （LCX） was 13.8%, the right coronary artery （RCA） was 27.6%, the left main 0.07%. 127 arteries were interfered by PCI, and the stents in LAD was （3.25±0.34）mm×（23.47±4.36）mm, LCX： （3.01±0.32）mm×（23.27＋5.87）mm,RCA： （3.60±0.43） mm×（26.83±4.43）mm. Conclusion Most of the youth patients suffer CHD abruptly and seriously. About half of the patients have the lesions in LAD. Smoking, hyperlipdemia, serious overweight and hypertension are the important risk factors.