青年男性急性心肌梗死的危险因素及介入治疗后1年随访分析  

Risk factor analysis and 1-year follow-up of patients undergoing percutaneous coronary intervention in young men with acute myocardial infarction

作　　者：刘颖[1] 蔡建华[1] 鄢华[1] 苏晞[1] 

机构地区：[1]武汉亚洲心脏病医院心内科,430022

出　　处：《中国心血管杂志》2014年第3期172-175,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的分析青年男性急性心肌梗死患者的临床危险因素,及接受冠状动脉介入治疗患者的1年期预后。方法纳入2008年1月至2012年1月在我院诊断为急性心肌梗死的男性患者727例,其中年龄≤40岁的急性心肌梗死患者322例,年龄≥60岁的急性心肌梗死患者405例,对比两组临床资料;对两组中行冠状动脉介入治疗的537例患者进行1年随访研究。结果青年组患者的吸烟、饮酒、肥胖、早发冠心病家族史比例及血三酰甘油、血浆纤维蛋白原水平高于老年组,apoA1水平低于老年组,差异有统计学意义(均为P<0.05),两组间糖尿病史比例、总胆固醇、HDL-C、LDL-C、apoB及尿酸水平差异无统计学意义(均为P>0.05)。Logistic回归分析显示,吸烟(P=0.008)、肥胖(P=0.013)、早发冠心病家族史(P=0.022)、高三酰甘油(P=0.021)是青年男性患AMI的独立危险因素。青年组PCI术后1年全因死亡率、复合MACE发生率、靶血管重建率、心力衰竭再住院发生率较老年组低(均为P<0.05)。结论 40岁以下青年男性急性心肌梗死的危险因素是吸烟、早发冠心病家族史、肥胖、高三酰甘油;青年男性急性心肌梗死患者行介入治疗1年随访预后良好。Objective Study on the clinical risk factors in young male patients with acute myocardial infarction （AMI）, and 1-year follow-up of patients who undergoing percutaneous coronary intervention （PCI）. Methods Collected clinical datum of 727 male patients with acute myocardial infarction, including 322 cases of AMI whose ages ≤40 years （young group） and 405 cases of AMI whose ages ≥60 years （old group）. Clinical datas and risk factors including smoking,drinking, early CHD familial history, obesity, hypertension and diabetes were compared between the two groups. In two group 537 patients undergoing percutaneous coronary intervention were followed-up for 1-year. Results The incidence of risk factors including smoking,drinking, obesity, early CHD familial history and the levels of triglyceride （TG） , fibrinogen was significantly higher in young group than in old group, apoprotein A1 （ apoA1 ） was lower than old group （all P 〈 0. 05 ）. The incidence of diabetes and levels of TC, HDL-C, LDL-C, apoB, UA had no significant difference between the two groups. Logistic regression analysis showed that smoking （P = 0. 008 ）, obesity （P = 0. 013） ,familial history of CHD （P =0. 022） and high TG （P =0. 021 ） was independent risk factors in males ≤40 years with AMI. The incidence of all-cause death, composite major adverse cardiac events （ MACE）, target vessel revascularization and heart failure hospitalization again in young group was significantly lower than that of old group during 1-year follow-up of PCI （ all P 〈 0. 05 ）. Conclusions Smoking, obesity, early familial history of CHD and high TG were independent risk factors of AMI in men under the age of 40. The young male patients with AMI had better 1-year prognosis with PCI.

关 键 词：青少年 急性冠状动脉综合征 危险因素 预后 

分 类 号：R542.22[医药卫生—心血管疾病]