青老年急性心肌梗死患者临床危险因素及发病节律性的比较性研究  

A comparative study of clinical risk factors and rhythm of onset in young and old patients with acute myocardial infarction

作　　者：牛文豪[1] 伍锋[1] 赵馨娜 王家美[1] 贺治青[1] 楚杨 王新 纪瑞圳 梁春[1] Niu Wenhao;Wu Feng;Zhao Xinna;Wang Jiamei;He Zhiqing;Chu Yang;Wang Xin;Ji Ruizhen;Liang Chun(Department of Cardiology,Shanghai Changzheng Hospital,Second Military Medical University,Shanghai 200001,China)

机构地区：[1]上海市第二军医大学长征医院心血管内科,200001

出　　处：《疑难病杂志》2020年第4期325-329,334,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：国家自然科学基金资助项目(91539118、81611130092)。

摘　　要：目的观察青老年急性心肌梗死患者临床危险因素及发病节律性变化。方法收集自2016年9月—2018年6月上海4所三甲医院收治入院的急性心肌梗死患者423例作为研究对象,最终纳入研究380例,青年患者(年龄≤45岁)143例,老年患者(年龄≥65岁)237例;分析青老年急性心肌梗死患者的危险因素及发病节律模式。结果与老年患者比较,青年心肌梗死患者中男性和吸烟的比例及血清总胆固醇、低密度脂蛋白胆固醇和三酰甘油浓度更高(t/χ^2=28.500、65.685、92.084、2.680、3.720、4.277,P均<0.001);上午(06∶01~12∶00)青年患者较老年患者更易发生急性心肌梗死。Logistic回归分析示,男性、高血压病史、糖尿病病史、卒中病史、冠心病家族史和吸咽史是青老年急性心肌梗死患者的危险因素(P<0.05)。结论男性和吸烟是青年心肌梗死患者的主要危险因素,青年患者容易在上午罹患急性心肌梗死。Objective To observe the clinical risk factors and the rhythmic changes of the onset of acute myocardial infarction in young and old patients.Methods From September 2016 to June 2018,423 patients with acute myocardial infarction admitted to four top three hospitals in Shanghai were collected as research objects,and 380 patients were finally included in the study,143 young patients(age≤45 years old)and 237 old patients(age≥65 years old).To analyze the risk factors and rhythm pattern of young and old patients with acute myocardial infarction.Results Compared with the elderly patients,the proportion of men and smokers,the concentration of serum total cholesterol,low-density lipoprotein cholesterol and triacylglycerol in the young patients with myocardial infarction were higher(t/χ^2=28.500,65.685,92.084,2.680,3.720,4.277,P<0.001);the young patients were more likely to have acute myocardial infarction in the morning(06∶01-12∶00).Logistic regression analysis showed that male,history of hypertension,history of diabetes,history of stroke,family history of coronary heart disease and history of swallowing were the risk factors of young and old patients with acute myocardial infarction(P<0.05).Conclusion Men and smoking are the main risk factors of young patients with myocardial infarction,young patients are prone to suffer from acute myocardial infarction in the morning.

关 键 词：心肌梗死 急性 临床特点 危险因素 昼夜节律 青年人 老年人 

分 类 号：R54[医药卫生—心血管疾病]