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1、35岁以下青年急性心肌梗塞患者临床特点分析【摘要】「I的：探讨急性心肌梗塞(AMI)青年患者的临床特点，为其早期诊治提供决策依据。方法：选择近10年來住院的117例35岁以下AMI患者资料，并以同期住院的355例65岁以上AM1老年患者作刈照，对比分析其病史、临床、用药及冠脉造影资料。结果：青年AMI患者中,吸烟(66.7%)、男(96.6%)、有家族史(30.0%)、ST段抬高(69.2%)、前壁AMI(43.6%)显著多于老年组(P均<0.05)o青年组低密度脂蛋白■胆固醇(LDL-C)水平较老年组明显升高[(2.93±1.48)
2、mmol/L:(2.35±1.21)mmol/L,PvO.O5]。超声心动图结果显示,青年组AMI后左室射血分数(LVEF)较老年组有明显提高[(59.82±10.86)%:(48.31±12.48)%,PvO.O5]。冠脉造彩结果显示，青年组最显著特点是大多数为单支(66.7%)、左前降支病变(69.3%),且其冠脉痉挛发牛率较老年组显著提高(6.8%:0.56%,P均<0.05)o青年组在AMI后的院内死亡率(2.6%:8.7%)及主要不良心血管事件发生率：1个月(3.4%:11.2%)和12个月(14.5%:24.8%)均明显好
3、于老年组(P均<0.05)o结论：35岁以下青年急性心肌梗塞患者吸烟、血脂代谢异常、家族史是主要危险因素。应在青年人群屮宣传并指导戒烟，改变不良生活方式，做好早期预防，以降低青年人急性心肌梗塞发病。【关键词】心肌梗塞清年期;危险因素Abstract：Objective：Toanalyzetheclinicalcharacteristicsofyoungpatientsagedlessthan35yearsoldwithacutemyocardialinfarction(AMI)andprovideevidenceforearlydia
4、gnosisandtreatmentofAMLMethods：Dataof117youngpatients<35yearsoldwithAMIadmittedinourhospitalduringrecent10yearswerechosenandanother355agedpatients>65yearsoldwithAMIadmittedinthesameperiodwerechosenascontrol.Dataoftheirdiseasehistory,clinicaldata,medicationandcoronaryang
5、iographywerecomparedandanalyzed.Results：AmongtheyoungpatientswithAMLthosewhohadcoronaryarterydiseasefamilyhistory(30.0%),smokedcigarettes(66.7%)andwasmale(96.6%)weremorethanthoseofagedpatients(P<0.05all).STsegmentelevation(69.2%)andanteriorwallAMI(43.6%)weremoreseeninyo
6、ungpatients.Comparedwithagedpatients,youngpatientspossessedhigherleveloflowdensitylipoprotein-cholesterol[LDL-C,(2.35±1.21)mmol/Lvs.(2.93±1.48)mmol/L,Pv0.05],higherleftventricularejectionfraction[LVEF,(4&31±12.48)%vs.(59.82±10.86)%,P<0.05]afterAMLResultsofcoronaryangiog
7、raphyindicatedthatmostoftheyoungpatientswereofsingle-vesselcoronarydisease(66.7%),leftanteriordescendinglesion(69.3%);incidencerateofcoronaryspasmwassignificantlyhigherinyoungpatientsthanthatofagedpatients(6.8%vs.0.56%,P<0.05).In-hospitaldeath(2.6%vs.8.7%),andmajoradver
8、secardiovasculareventsafteronemonth(3.4%vs.11.2%)and12months(14.5%vs.24.8%)ofyoungpatientsweresignificantlybet
