30歲以下急性ST段抬高型心肌梗死患者臨床特點分析

　　摘   要：目的  探討30歲以下急性ST段抬高型心肌梗死患者的臨床特點。方法  選擇首次發(fā)病的STEMI患者51例，按年齡分青年組17例（年齡18～30歲），對照組34例（年齡≥31歲），對兩組人群常見的危險因素、臨床特點、冠狀動脈病變特點以及發(fā)病30 d內主要不良心血管事件發(fā)生率進行對比分析。結果  ①青年組中男性、吸煙、合并高血壓、合并高脂血癥患者比例明顯高于對照組，差異有統(tǒng)計學意義（P<0.05）;青年組體質量指數(shù)、左心室射血分數(shù)以及血清總膽固醇、甘油三酯、低密度脂蛋白膽固醇水平明顯高于對照組，總膽紅素水平低于對照組，差異有統(tǒng)計學意義（P<0.05）;②青年組“罪犯血管”病變類型以單支病變、A型病變?yōu)橹鳎瑢φ战M多為三支病變、分叉病變、C型病變，差異有統(tǒng)計學意義（P<0.05）;③青年組發(fā)病30 d內梗死后心絞痛、心力衰竭、惡性心律失常的發(fā)生率明顯低于對照組，差異有統(tǒng)計學意義（P<0.05）。結論  男性、吸煙、合并高血壓、合并高脂血癥是30歲以下STEMI患者突出的危險因素，其冠脈病變多為單支、A型病變，發(fā)病30 d內臨床預后良好。
　　關鍵詞：青年;心肌梗死;危險因素;冠脈造影
　　中圖分類號：R542.22                                 文獻標識碼：A                               DOI：10.3969/j.issn.1006-1959.2018.05.026
　　文章編號：1006-1959（2018）05-0081-03
　　Clinical Characteristics of Acute ST-segment Elevation Myocardial Infarction under 30 Years of Age
　　ZHAI Gong-wei，ZHAO Pei-hua，HUA Yan
　　（Department of CCU，Jinghai District Hospital，Tianjin 301600，China）
　　Abstract：Objective  To investigate the clinical characteristics of acute ST segment elevation myocardial infarction（AMI）patients under 30 years of age.Methods  51 STEMI patients with first onset were divided by age youth group of 17 cases（age 18～30），the control group of 34 cases（aged≥31 years），risk factors，two groups of common clinical features，characteristics of coronary artery lesions and within 30 d of onset of major adverse cardiovascular events incidence were compared analysis.Results  ①The youth group in male，smoking，hypertension，and hyperlipidemia patients were significantly higher than the control group，the difference was statistically significant（P<0.05）;youth group，body mass index，left ventricular ejection fraction，serum total cholesterol，triglyceride，low density lipoprotein cholesterol levels were significantly higher than the control group，the total bilirubin level compared with the control group， the difference was statistically significant（P<0.05）.②In the young group，the types of"criminals blood vessels"were mainly single vessel lesion and A type lesion.The control group had three branches，bifurcation lesions and C lesions.The difference was statistically significant（P<0.05）.③The incidence of angina pectoris， heart failure and malignant arrhythmia in the young group was significantly lower than that in the control group within 30 d after onset，and the difference was statistically significant（P<0.05）.Conclusion  Men， smoking，hypertension and hyperlipidemia are prominent risk factors for STEMI patients under 30 years old.Their coronary lesions are mostly single and A lesions，and the prognosis is good within 30 d.

相關熱詞搜索：心肌梗死 抬高 臨床 患者 分析