青年急性心肌梗死的临床特点.docVIP

青年急性心肌梗死的临床特点 　　作者：蔡雪黎,胡开宇,计光,张怀勤,黄伟剑,林　　作者单位：温州医学院附属第一医院 心血管内科，浙江 温州 　　【摘要】目的：探讨急性心肌梗死(AMI)的临床特点在青年与老年患者间的差异。方法：对1996年9月至2006年9月我科收住的51例青年AMI患者与同期随机抽取166例老年AMI患者的危险因素、发病情况、临床表现、并发症及冠状动脉造影(CAG)结果进行回顾性分析。结果：青年组与老年组相比，男性(占96.1%)、大量吸烟(占80.4%)、有精神压力大等明确诱因(占68.6%)、酗酒史(占54.9%)为主要发病危险因素(P 0.01);临床表现多为突发胸痛，症状典型(P 0.05);心肌梗死范围局限，以前壁为主，病死率及并发症的总发生率低(P 0.01);冠脉病变以单支病变为主(P 0.01)，且侧枝循环形成少(P 0.01)。结论：男性、大量吸烟、存在精神压力大等明确诱因、酗酒是青年AMI的主要危险因素，临床多表现为突发典型胸痛，多为单支冠脉病变，侧枝循环少，梗死范围局限，并发症发生率低，预后好。培养青年良好的生活习惯，及时予以再灌注治疗对青年AMI的防治具有重要意义。 　　【关键词】 青年,急性心肌梗死,危险因素,临床特点,冠状动脉造影术 　　Abstract: Objective: To explore the difference of the characteristics of acute myocardial infarction (AMI) in the young patients and in the elderly. Methods: The patients， who were confirmed to be diagnosed AMI from September 1996 to September 2006， were divided into two groups: the young patients(YP) group of 51 cases and the old patients (OP) group of 166 cases. They risk factors，clinical characteristics and the results of coronary angiography(CAG) were analyzed. Results: Campared with OP group，male (96.1%)，smoking (80.4%)， clear incentive (64.6%) and alcoholism (54.9%) were the main risk factors in the YP group (P 0.01). Incidence of typical clinical manifestations in YP group was higher than that in OP group (P 0.05). Mortality and the incidence of complication in YP group was lower than that in OP group (P 0.01). Morbidity of patients with single coronary lesion in YP group was higher than that in OP group. Conclusion: Male， smoking， clear incentive and alcoholism were the main risk factors in the Youth AMI patients. Youth AMI patients were the clinical manifestations of sudden angina pectoris， less complications，low mortality and favorable prognosis. Good habits， life style and timely reperfusion therapy are of great significance to prevent disease and to improve prognosis. 　　Key words: young people ;acute myocardial infarction ;risk factor;clinical characteristics;coronary artery angiography 　　急性心梗死