30岁以下青年急性心肌梗死的临床特点与随访研究

目的 观察30岁以下青年急性心肌梗死的临床特点与随访结果,探讨其病因,以指导防治.方法选择2007年1月至2011年5月在辽宁省人民医院确诊的30岁以下急性心肌梗死患者17例,分析其危险因素、诱因、冠状动脉造影特点,并对其进行随访.结果患者均为未婚男性,年龄26～29(27.8±1.2)岁,吸烟者占82.4%,冠心病家族史占35.3%,肥胖占11.8%,高脂血症占11.8%,高血压占5.9%,糖尿病占5.9%,有过度疲劳、精神压力大等诱因者占88.2%.冠脉造影显示单支、双支、三支病变分别为13例、2例、2例,均成功进行急诊介入治疗.随访12～57(26.4±29.7)个月,17例患者均存活,无心力衰竭或再发急性心肌梗死.其中1例(占5.9%)术后31个月出现心绞痛,再次进行冠状动脉介入治疗.结论 30岁以下青年急性心肌梗死的高危因素是男性、大量吸烟,多有过度疲劳、精神压力大等诱因,冠脉造影多为单支病变,及时介入干预与改善生活方式预后良好.

Clinical characteristics and follow-up study of acute myocardial infarction in young adults under 30 years old

Objective To observe the clinical characteristics and follow-up results of acute myocardial infarction（AMI ） in young patients under 30 years old, and explore the possible mechanism to guide prevention and cure. Methods Seventeen patients under 30 years old were diagnosed AMI in the People＇s Hospital of Liaoning Province from January 2007 to May 2011. The risk factors, inducement, and results of coronary angiography and follow-up were summarized. Results All patients were unmarried male youth of 26-29 （27.8±1.2） years old . 82.4% of patients had smoking history. 35.3% of them had coronary heart disease history. 11.8% of them suffered adipositas. 11.8% of them suffered hyperlipidemia. 5.9% of them suffered hypertension. 5.9% of them suffered diabetes mellitus. 88.2% of them suffered overtiredness or high stress. The number of single coronary artery vessel disease, double coronary artery vessels disease, and three coronary artery vessels disease were 13, 2 and 2. All patients were survival without heart failure or relapse AMI during the course of follow-up of 12-57 months. One patient suffered angina pectoris 31 months after PCI, and he was cured by PCI again. Conclusion The high risk factors of AMI in young patients under 30 years old were male, smoking, overtiredness or stress. Single coronary artery vessels disease is more frequently detected by angiography in such patients, Timely reperfusion therapy and the removal of risk factors are of importance to reduce morbidity and mortality and to improve prognosis.