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目的分析青年男性急性ST段抬高性心肌梗死(STEMI)的临床特点及冠状动脉造影特点,探讨如何预防青年人急性心肌梗死。方法对于年龄<45岁的青年男性STEMI患者50例(A组)和同期年龄>65岁的老年男性STEMI患者50例(B组)进行对比观察,从危险因素、临床特点、冠状动脉病变程度、并发症及预后等方面进行比较。结果①A组患者多有吸烟史(78%比34%,P<0.05)及早发冠心病家族史(40%比10%,P<0.05),两组基础综合征各项指标中仅低密度脂蛋白胆固醇差异有统计学意义(48%比36%,P<0.05)。基础心功能A组均正常,B组正常中占86%,差异具有统计学意义(P<0.05)。A组中AMI后心功能Killip II~IV级占4%,B组为48%(P<0.05);②A组单支病变发生率为76%,多侵犯LAD;而B组双支及三支病变发生率为84%。结论吸烟、家族遗传因素及低密度脂蛋白胆固醇是青年男性STEMI最重要的危险因素,冠脉病变以单支血管病变为主。
Objective To analyze the clinical features and coronary angiography of acute ST-segment elevation myocardial infarction (STEMI) in young men and to explore how to prevent acute myocardial infarction in young people. Methods Fifty patients (group A) with STEMI in young men <45 years of age and 50 elderly patients with STEMI (aged 65 years) in the same period were enrolled in this study. The risk factors, clinical features, degree of coronary artery disease, Complications and prognosis were compared. Results ① The patients in group A had more smoking history (78% vs 34%, P <0.05) and family history of premature coronary heart disease (40% vs 10%, P <0.05). Only the low density lipids Protein cholesterol differences were statistically significant (48% vs 36%, P <0.05). The basal cardiac function in group A was normal, while in group B, 86% was normal, the difference was statistically significant (P <0.05). In group A, Killip class II-IV was 4% after myocardial infarction, and 48% in group B (P <0.05). The incidence of single-vessel disease in group A was 76% The incidence of lesions was 84%. Conclusion Smoking, family genetic factors and low density lipoprotein cholesterol are the most important risk factors for STEMI in young men. Coronary artery disease is predominantly single vessel disease.