摘要
【目的】探讨影响45岁以下急性ST段抬高心肌梗死患者(acute ST-segment elevation myocardial infarction,STEMI)的临床特点、发病的主要危险因素及影响预后的因素。【方法】回顾性收集2016年1月至2019年1月期间在合肥市第三医院确诊的年龄≤45岁的21名急性ST段抬高心肌梗死患者病例资料。同时收集同期年龄大于60岁的老年患者的病例数据为对比,根据患者的年龄分为青年组(≤45岁)和老年组(>60岁),回顾性分析两组数据的临床病例特点和随访1年的主要不良心血管事件(major adverse cardiovascular events,MACE)发生,分析青年STEMI患者的发病危险因素。【结果】21例青年人急性心肌梗死病例中,平均年龄39.57岁,其中男性20例(95.2%),随访时间为1年,其中出现不良事件2例(9.53%),均为PCI术后未戒烟者,未出现1例死亡患者。与老年组(>60岁)对比中两组在年龄、糖尿病史、高血脂、吸烟史、BMI水平、胆固醇、LDL水平、BNP水平存在差异(P<0.05),差异有统计学意义;年轻STEMI患者的主要诱因是情绪应激(38.09%),最常见的症状为心绞痛(80.95%),随访1年的MACE事件发生率是9.52%,主要是再发心梗。【结论】对于青年人急性ST段抬高心肌梗死,急诊PCI术后经过规范的药物治疗后临床效果好,远期不良心血管事件发生率低,吸烟是影响长期预后的主要危险因素。
【Objective】To investigate the clinical characteristics,main risk factors and prognostic factors of acute st-segment elevation myocardial infarction(STEMI)in patients under 45 years old.【Methods】The data of 21 patients with STEMI under 45 years old diagnosed in the third hospital of Hefei from January 2016 to January 2019 were collected.The case data of older patients over 60 years old were also collected during the same period for comparison.According to the age of the patients,they were divided into the youth group and the elderly group.The clinical features of the data of the two groups and the occurrence of MACE events with 1-year followup were compared to analyze the risk factors of the onset of the disease in the young STEMI patients.【Results】Among the 21 cases of acute myocardial infarction in young people,the mean age was 39.57 years,and 20 cases(95.2%)were male.The 21 young patients with acute myocardial infarction were followed up for 1 year,and 2 of them(9.53%)had adverse events.All of them were non-smokers after PCI,and no one died.Compared with the elderly group(>60 years old),there was difference in age,diabetes,hyperlipidemia,smoking,BMI level,cholesterol,LDL level and BNP level between the two groups(P<0.05),and the difference was statistically significant.The primary cause of STEMI in young patients was emotional stress(38.09%),the most common symptom was angina(80.95%),and the incidence of MACE events in 1-year follow-up was 9.52%,mainly recurrent myocardial infarction.【Conclusion】For acute stsegment elevation myocardial infarction in young people,the clinical efficacy of standardized drug therapy after emergency PCI is good,the incidence of long-term adverse cardiovascular events is low,and smoking is the main risk factor affecting long-term prognosis.
作者
陈厚良
刘圣好
盛春梅
程小兵
陈东
钟万生
潘文博
CHEN Hou-liang;LIU Sheng-hao;SHENG Chun-mei;CHENG Xiao-bing;CHEN Dong;ZHONG Wan-sheng;PANWen-bo(Hefei Third People's Hospital,Hefei 230000,China)
出处
《武警后勤学院学报（医学版）》
CAS
2020年第10期30-34,共5页
Journal of Logistics University of PAP（Medical Sciences）
关键词
急性心肌梗死
青年人
临床特点
预后
Acute myocardial infarction
Young people
Clinical characteristics
Prognosis
