高原中青年急性ST段抬高型心肌梗死患者的临床特点和近期预后  

Clinical characteristics and short-term prognosis of acute ST-segment elevation myocardial infarction in young and middle-aged people in plateau

作　　者：张海波[1] 吴鹏[1] 任平[1] 龙毅[1] 李琛[1] 黄正林[1] 邹礼华[1] 雷敏[1] ZHANG Hai-bo;WU Peng;REN Ping;LONG Yi;LI Chen;HUANG Zheng-lin;ZOU Li-hua;LEI Min(Department of Cardiology,Ya′an People′s Hospital,Ya′an,Sichuan 625000,China)

机构地区：[1]雅安市人民医院心内科,四川雅安625000

出　　处：《岭南心血管病杂志》2018年第1期30-33,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的研究直接经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗的高原中青年(年龄≤50岁)急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者的临床特点及近期预后情况。方法收集雅安市人民医院2010年1月至2016年1月接受PCI治疗的全部中青年STEMI患者资料,根据海拔高度将患者分为平原组(120例)和高原组(92例)。比较分析危险因素、冠状动脉情况及90 d预后。结果本研究共入选212例STEMI患者,年龄(41.3±8.1)岁,男172例(81.1%)。平原组和高原组的原发性高血压(高血压)患者比例分别是24.2%和52.2%,血糖异常比例分别是18.3%和32.6%,血脂异常比例分别是41.7%和57.6%,高敏肌钙蛋白T峰值分别是(575±67)pg/m L和(1 624±379)pg/m L,高原组与对照组比较有显著升高趋势,差异有统计学意义(P<0.05);肥胖比例分别是62.5%和30.4%,精神抑郁比例分别是35.8%和12.0%,冠状动脉粥样硬化性心脏病(冠心病)家族史比例分别是30.0%和16.3%,高原组与对照组比较有显著降低趋势,差异有统计学意义(P<0.05);患者症状-入门时间分别为385.4(42~695)min和542.5(110~876)min,多支血管病变比例分别是10.0%和21.7%,高原组与对照组比较有显著升高趋势,差异有统计学意义(P<0.05)。在90 d预后方面,高原组和平原组心肌梗死再发率分别是0.83%和6.52%,心力衰竭发生率分别是11.7%和23.9%,高原组与对照组比较有升高趋势,差异有统计学意义(P<0.05)。结论高原中青年STEMI患者比平原患者合并高血压、血糖异常、血脂异常的比例更高,冠状动脉多支病变比例、再发心肌梗死和心力衰竭发生率更高。Objectives To investigate the clinical characteristics and short-term prognosis of acute ST-segment eleva?tion myocardial infarction(STEMI)who underwent primany percutaneous coronary intervention(PCI)in young andmiddle-aged people in plateau.Methods Totally212consecutive middle-aged and young patients with STEMI whounderwent primary PCI were recruited in Ya′an People′s Hospital from January2010to January2016.According to alti?tude,the patients were divided into plain group(120cases)and plateau group(92cases).Risk factors,characteris?tics of coronary lesions and90-day outcomes were assessed and compared in the two groups.Results A total of212patients with STEMI were enrolled in this study,with an average age of(41.3+8.1)years and172males(81.1%).Proportion of hypertension(52.2%vs.24.2%),abnormal blood glucose(32.6%vs.18.3%),dyslipidemia(57.6%vs.41.7%)and peak value of high sensitive troponin T[(1624±379)pg/mL vs.(575±67)pg/mL]in plateau group were statistically significantly higher than those in plain group(P<0.05).Proportion of obesity(30.4%vs.62.5%),depression(12.0%vs.35.8%),family history of coronary heart disease(16.3%vs.30.0%)in plateau group were significantly lower than those in plain group(P<0.05).Compared with plain group,attack-door duration[385.4(42-695)min vs.542.5(110-876)min]and patients with multivessel disease(10.0%vs.21.7%)in plateau group significantly increased(P<0.05).Compared with plain group recurrence rate of myocardial infarction(6.52%vs.0.83%)and incidence of heart failure(23.9%vs.11.7%)in plateau group significantly increased(P<0.05).Conclusions Proportions of patients with hypertension,abnormal blood glucose and dyslipidemia in STEMI patients in plateau are higher than those in plain.The proportion of coronary artery multivessel disease,recurrent myocardial infarction and heart failure are higher.

关 键 词：心肌梗死 血管成形术 经腔 经皮 高原 中青年 

分 类 号：R542.22[医药卫生—心血管疾病]