目的探讨青年男性冠心病危险因素、冠状动脉病变、主要心血管不良事件(MACE)与中老年男性患者存在的差异,为探索男性早发冠心病发病机制提供临床依据。方法回顾性分析2011年1月至2013年9月经冠状动脉造影确诊为冠心病的男性患者476例,根据年龄分为青年组、中老年组。收集两组身高、体质量、体质量指数(BMI),既往高血压病、血脂异常、糖尿病、吸烟以及早发冠心病家族史;两组血液生化指标包括血尿酸(UA)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、脂蛋白(α)[LP(α)]、空腹血糖(FBG);两组冠状动脉造影结果,住院期间及1年内MACE发生率。结果与中老年男性冠心病组相比,青年组糖尿病、高血压病比例,TC、LDL-C、Lp(α)、UA水平较低(P<0.01);血脂异常、早发冠心病家族史、吸烟史比例,BMI、TG、HDL-C水平较高(P<0.05);两组冠状动脉病变均以前降支病变比例最高,青年冠心病组以单支病变为主、多支病变比例最低,中老年组多支病变比例最高、单支病变比例最低。住院期间及1年内MACE发生率青年组均低于中老年组(P<0.05)。结论青年男性冠心病患者主要危险因素有吸烟、高三酰甘油血症、早发冠心病家族史、超重/肥胖;冠状动脉病变以单支病变为主,主要表现为前降支病变,MACE发生率较低。控制体质量、戒烟、控制血脂水平可能有助于减少青年男性冠心病的发生。 Objective To investigate the differences of risk factors of coronary heart disease, coronary artery disease, major cardiovascular adverse events (MACE) between young men and middle-aged and elderly men, and to provide a clinical basis for exploring the pathogenesis of premature coronary heart disease in men. Methods A retrospective analysis of 476 male patients diagnosed as coronary heart disease by coronary angiography from January 2011 to September 2013 was divided into young group and middle-aged group according to their age. The family history of hypertension, dyslipidemia, diabetes mellitus, smoking and early-onset coronary heart disease were collected. Two groups of blood biochemical parameters including serum uric acid (UA), total cholesterol (TG), LDL-C, HDL-C, LP (a) and fasting blood glucose (FBG) Group coronary angiography results, MACE incidence during hospitalization and 1 year. Results Compared with middle-aged and elderly men with coronary heart disease, the rates of diabetes, hypertension, the levels of TC, LDL-C, Lp (α) and UA were lower in the youth group (P <0.01) , Smoking history, BMI, TG and HDL-C were higher (P <0.05). The coronary lesion in both groups had the highest proportion of anterior descending coronary artery disease, the single coronary artery disease in young coronary heart disease group and the lowest multi-vessel disease The proportion of multi-vessel disease in middle-aged and elderly group was the highest, and the proportion of single vessel disease was the lowest. The incidence of MACE during hospitalization and within 1 year was lower in young group than in middle-aged and elderly group (P <0.05). Conclusion The main risk factors of coronary heart disease in young men are smoking, hypertriglyceridemia, family history of premature coronary heart disease, overweight / obesity; coronary artery disease is dominated by single vessel disease, which is mainly characterized by anterior descending coronary artery disease, MACE incidence Lower. Control of body mass, smoking cessation, blood lipid levels may help reduce the incidence of coronary heart disease in young men.