青年人急性心肌梗死的临床特点分析

发布时间：2018-06-23 00:49

本文选题：青年人 + 急性心肌梗死　；参考：《新疆医科大学》2013年硕士论文

【摘要】：目的：探讨青年人急性心肌梗死(acute myocardial infarction, AMI)的危险因素、临床表现和冠状动脉病变特点。方法：回顾性分析2009年8月至2012年10月在新疆医科大学第五附属医院心内科住院诊断为AMI并行冠状动脉造影检查的青年患者70例、老年患者80例，并选取同期住院排除冠心病诊断并行冠状动脉造影检查的青年患者70例。收集三组患者吸烟史、早发冠心病家族史、高血压病病史、2型糖尿病病史、临床表现、辅助检查结果等临床资料，从而总结出青年人AMI的临床特点。结果：①青年AMI组FG、TC、TG、LDL-C、吸烟、高血压病、2型糖尿病、早发冠心病家族史与对照组比较差异具有统计学意义(P＜0.05)。logistic回归分析显示：高血压病(OR=5.795)、2型糖尿病(OR=4.528)、早发冠心病家族史(OR=2.892)、吸烟(OR=2.136)均为青年AMI的独立危险因素。②青年AMI患者前驱症状、典型胸痛症状与老年AMI组有显著性差异(P＜0.01)。两组AMI患者梗死类型均以急性ST段抬高型心肌梗死(segment elevation myocardial infarction,STEMI)为主，差异无统计学意义(P＞0.05)。③青年AMI组冠状动脉造影正常者占有一定比例(8.57%);单支病变、三支病变、弥漫性病变及侧枝循环情况与老年AMI组比较均有统计学差异(P 0.05)。结论：青年AMI者的独立危险因素依次为高血压病、2型糖尿病、早发冠心病家族史、吸烟；临床表现为:前驱症状少，常有典型胸痛症状，心肌梗死类型以ST段抬高型心肌梗死(STEMI)为主；冠状动脉造影结果正常者占一定比例，，并以单支病变为主。
[Abstract]:Objective: to investigate the risk factors, clinical manifestations and coronary artery disease characteristics of young patients with acute myocardial infarction (acute myocardial infarction,). Methods: from August 2009 to October 2012, 70 young patients with AMI and 80 elderly patients with AMI in Department of Cardiology, Fifth affiliated Hospital of Xinjiang Medical University, were analyzed retrospectively. A total of 70 young patients who excluded coronary heart disease and underwent coronary angiography in the same period were selected. The history of smoking, the family history of early coronary heart disease, the history of hypertension and the history of type 2 diabetes mellitus were collected, and the clinical features of AMI in young people were summarized. Results in young AMI group, FGG TCU TGG LDL-C, smoking, hypertension and type 2 diabetes mellitus were observed. Logistic regression analysis showed that hypertension (OR5.795) type 2 diabetes mellitus (OR4.528), familial history of early coronary heart disease (OR2.892), smoking (OR2.136) were independent risk factors of young AMI. Prodromal symptoms in AMI patients, There was significant difference between the typical chest pain symptom and the elderly AMI group (P < 0.01). The infarct type of acute ST-segment elevation myocardial infarction (segment elevation myocardial) was the main type in the two groups (P > 0. 05). There was no significant difference (P > 0. 05) in the proportion of patients with normal coronary artery angiography (8. 57%), single vessel lesion and three vessel lesion in young AMI group (P > 0. 05), and there was no significant difference between the two groups (P > 0. 05). There were significant differences in diffuse lesion and collateral circulation between the elderly AMI group and the elderly group (P 0.05). Conclusion: the independent risk factors of young patients with AMI are hypertension type 2 diabetes mellitus, early family history of coronary heart disease and smoking. St segment elevation myocardial infarction (STEMI) was the main type of myocardial infarction, and normal coronary angiography was the most common type of myocardial infarction.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R542.22

【参考文献】