文章摘要
邵明学,李小波,张辛颖,朱 灏,郑亚国.青年初发急性心肌梗死患者的临床特征及危险因素分析[J].,2023,(14):2791-2795
青年初发急性心肌梗死患者的临床特征及危险因素分析
Analysis of the Clinical Features of Young Adults with First Acute Myocardial Infarction and its Risk Factors
投稿时间:2022-11-23  修订日期:2022-12-19
DOI:10.13241/j.cnki.pmb.2023.14.037
中文关键词: 青年  初发急性心肌梗死  危险因素  左室射血分数
英文关键词: Young adults  First acute myocardial infarction  Risk factors  Left ventricular ejection fraction
基金项目:国家自然科学基金项目(81900248)
作者单位E-mail
邵明学 南京医科大学附属南京医院(南京市第一医院)心血管内科 江苏 南京 210001 mingxuesh@163.com 
李小波 南京医科大学附属南京医院(南京市第一医院)心血管内科 江苏 南京 210001  
张辛颖 南京医科大学附属南京医院(南京市第一医院)心血管内科 江苏 南京 210001  
朱 灏 南京医科大学附属南京医院(南京市第一医院)心血管内科 江苏 南京 210001  
郑亚国 南京医科大学附属南京医院(南京市第一医院)心血管内科 江苏 南京 210001  
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中文摘要:
      摘要 目的:探讨青年初发急性心肌梗死(Acute myocardial infarction, AMI)的临床特点及其发生心功能下降的相关危险因素。方法:收集年龄<45岁的初发AMI且行冠脉造影检查的患者86例及同期60-75岁的患者96例,对两组患者的临床资料进行对比分析,并对青年组心功能下降的危险因素进行Logistic回归分析。结果:青年组年龄中位数为40岁,男性患者及吸烟人群比例显著高于老年组(P<0.01),高血压及糖尿病患者的比例显著低于老年组(P<0.001);血尿酸水平、甘油三酯、低密度脂蛋白胆固醇均显著高于老年组,而高密度脂蛋白胆固醇及脂蛋白(a)显著低于老年组(P<0.01);冠脉多支病变的比例和Gensini评分低于老年组(P<0.001),左室射血分数<40%的比例显著低于老年组(P<0.01)。两组罪犯血管为前降支、回旋支及右冠脉的比例比较无明显差异(P>0.05)。Logistic回归分析显示高尿酸和高冠脉Gensini评分是青年初发AMI患者心功能下降的危险因素(P<0.05)。结论:青年初发AMI以男性为主,吸烟、高尿酸、血脂异常更为多见,冠脉病变严重程度相对较轻,高尿酸和冠脉Gensini评分是青年初发AMI后心功能下降的危险因素。
英文摘要:
      ABSTRACT Objective: To explore the clinical features of young adults with first acute myocardial infarction (AMI) and risk factors for heart failure. Methods: Eighty-six patients with first AMI aged<45 years underwent coronary angiography and 96 elderly patients aged 60-75 years at the same time were included in this study. The clinical data and coronary artery lesions were compared, and Logistic regression analysis was conducted to screen the risk factors of heart failure. Results: The median age of the young group was 40 years old, the percentages of male, smokers, hypertension, and diabetes were significantly higher than those of the elderly group (P<0.01). The levels of uric acid, triglyceride and low density lipoprotein cholesterol were higher in the young group, however, the high density lipoprotein cholesterol and lipoprotein (a) levels were higher than elderly group(P<0.01). The proportion of coronary multi-vessel lesions and heart failure as well as the Gensini score in the young group were lower than those in the elderly group(P<0.01), but there was no significant difference in the culprit artery(P>0.01) between two groups. Logistic regression analysis showed that high uric acid and Gensini score were risk factors for heart failure after first AMI in young patients(P<0.05). Conclusion: Young adults with first AMI is mainly male. Smoking, elevated uric acid and dyslipidemia are more common in them. High level of uric acid and Gensini score are the risk factors for young patients enduring heart failure after first AMI.
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