摘要
目的 探讨吸烟对青年男性急性心肌梗死患者的影响.方法 入选2009年1月1日至2011年12月31日收住武警北京市总队医院及北京安贞医院,诊断急性心肌梗死并行冠状动脉造影手术的青年男性患者（年龄≤44岁）278例（心肌梗死组）,根据冠状动脉造影结果分为单支病变组（156例）及多支病变组（122例）,选择同期两所医院心内科住院行冠状动脉造影排除冠心病青年男性208例为对照组.观察吸烟与冠状动脉病变程度和在急性心肌梗死患者中的关系.结果 ①心肌梗死组吸烟比例（83.4％,232/278）高于对照组（65.4％,136/208）,多支病变组吸烟比例（89.3％,109/122）高于单支病变组（78.8％,123/156）（P＜0.05）;②心肌梗死组中,吸烟患者的高密度脂蛋白胆固醇（HDL-C）较非吸烟患者降低[（0.98±0.25） mmol/L比（1.09 ±0.40） mmol/L] （P ＜0.05）;心肌梗死组和冠状动脉正常组吸烟合并超重和肥胖的比例高于体质量正常组（P＜0.05）;心肌梗死合并代谢综合征患者中,吸烟患者比例（88.0％,147/167）高于不吸烟患者（11.9％,20/167） （P ＜0.05）.③Logistic回归分析显示,与青年男性急性心肌梗死独立相关的危险因素,依次为代谢综合征[比值比（OR）=4.125,95％置信区间（CI）：2.588～6.577,P＜0.01]、早发冠心病家族史（OR=3.903,95％CI：2.019 ～7.547,P＜0.01）、吸烟（OR=2.828,95％CI：1.698 ～4.711,P＜0.01）、血红蛋白（OR=1.053,95％ CI：1.033 ～1.073,P＜0.01）、尿酸（OR=1.004,95％ CI：1.001～1.006,P=0.003）.结论 吸烟是青年男性急性心肌梗死的独立危险因素.
Abstract： Objective To investigate the impact of smoking on coronary artery lesions in young men with acute myocardial infarction （AMI）.Methods Totally 278 young men with AMI were retrospectively studied and compared with 208 non-coronary heart disease （CHD） young men.All patients were admitted from January 2009 to December 2011 and underwent coronary angiography; the clinic and coronary angiographic features were assessed.According to the results of coronary angiography,the patients were divided into two groups：the single vessel lesion group and multiple-vessel lesion group.208 young men without CHD confirmed by the coronary angiography were enrolled in the control group.The relation among smoking,AMI and severity of the coronary artery disease were observed.Results ①The ratio of smoking was significantly higher in young men with AMI group compared to that in non-CHD young men group [83.4% （232/278） vs 65.4% （136/208）,P 〈0.05].In AMI group,the ratio of smoking in single lesions group was significantly lower than that in multiple vessel lesions groups [89.3 % （109/122） vs 78.8 % （123/156）,P 〈 0.05].②In the AMI group,the HDL-C levels were significantly lower than those in smoking group[（0.98 ± 0.25） mmol/L vs （1.09 ± 0.40） mmol/L,P 〈 0.05].In both AMI and non-CHD groups,the ratio of obesity and overweight patients were higher than those of normal weight group.In AMI patients with metabolic syndrome,the ratio of smokers was higher [88.0% （147/167） vs 11.9%（20/167）,P 〈 0.05].③Logistic regression analysis showed metabolic syndrome （OR =4.125,95 % CI：2.588-6.577,P 〈 0.01）,familial history of early coronary artery disease （OR =3.903,95% CI：2.019-7.547,P 〈0.01）,smoking history （OR =2.828,95% CI：1.698-4.711,P 〈 0.01）,hemoglobin （OR =1.053,95% CI：1.033-1.073,P 〈 0.01） and serum uric acid （OR =1.004,95 % CI：1.001-1.006,P =0.003） were independent risk factors （P 〈 0.05） for young men with AMI.Conclusion Smoking is an inde
出处
《中国医药》
2014年第10期1414-1418,共5页
China Medicine
关键词
心肌梗死
青年男性
吸烟
冠状动脉病变
Myocardial infarction
Adolescent
Smoking
Coronary artery disease
