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目的 分析青年男性急性ST段抬高型心梗(ST segment elevation myocardial infarction,STEMI)的危险因素和冠状动脉病变特点.方法 选取首都医科大学附属北京同仁医院住院诊断STEMI并直接行经皮腔内冠状动脉成形术(percutaneous transluminal coronary angioplasty,PTCA)的青年男性患者为病例组,共91例,选取同期住院并行冠脉造影检查排除冠心病的青年男性(63例)、同期住院诊断STEMI并直接PTCA的中年男性(79例)、老年男性(66例)为对照组.分析4组研究对象的临床资料、青年男性STEMI危险因素及STEMI组冠状动脉造影特点.结果 青年男性STEMI组,与青年男性对照组相比,超重、吸烟、2型糖尿病比例高,空腹血糖高(均P<0.05);与中年男性STEMI组相比,早发冠心病家族史比例低,总胆固醇、血红蛋白高,尿素氮低(均P<0.05);与老年STEMI组相比,血红蛋白、舒张压、总胆固醇、甘油三酯、体重指数高,糖化血红蛋白、尿素氮低,正常体重比例低(均P<0.05).与青年男性STEMI相关的危险因素依次是吸烟(OR=4.506)、糖化血红蛋白(OR=1.697)、舒张压(OR=1.041),空腹血糖(OR=0.296)(均P<0.05).青年男性STEMI组与中年、老年STEMI组比较,梗死相关血管好发于前降支,其次为右冠和回旋支,但三组间差异无统计学意义.其中,青年男性STEMI组以单支血管病变为主,45例(49.45%);中老年男性STEMI组以三支血管病变为主(P60 (elderly men with STEMI group). Results 1. In comparison with the young men without CAD control group, the proportions of overweight, smoking, and type 2 diabetes mellitus, and fasting blood glucose level of the young men with STEMI group were all significantly higher than those of the young men without CAD group (all P<0.05). Compared with the middle-aged men with STEMI group, the proportion of family history of premature CAD and urea nitrogen level of the young men with STEMI group were both significantly lower, and the levels of total cholesterol and hemoglobin were both significantly higher (all P<0.05). Compared with the old men with STEMI group, the proportion of normal weight, and the levels of glycosylated hemoglobin and blood urea nitrogen of the young men with STEMI group was all significantly lower;and the levels of hemoglobin, diastolic blood pressure, total cholesterol, triglyceride, and body mass index were all significantly higher (all P<0.05). 2. Smoking (OR 4.506), glycosylated hemoglobin (OR 1.697), diastolic pressure (OR 1.041), and fasting blood glucose (OR 0.296) were all independent risk factors (all P<0.05) for young men with STEMI. 3. In the young men with STEMI, the infarction related artery was oftren found to be the anterior descending artery, followed by right coronary artery and circumflex branch, but there were no significant differences among these three groups. The proportion of single vessel disease was 45%in the young men with STEMI group, and the proportion of three vessel diseases was higher in the middle-aged men with STEMI group (37.79%) and old men with STEMI group (43.94%) (P<0.05).Conclusion The onset age of AMI tends to be lower. The risk factors of STEMI and the characteristics of CAD in young men are different from those of the middle-aged and old people.