CAJ | 학술논문

目的分析不同年龄段急性心肌梗死(AMI)患者合并传统危险因素的现状,进而探讨不同危险因素对AMI发病年龄变化的影响.方法记录2003年10月至2010年10月收治的AMI(包括ST段抬高性心肌梗死及非ST段抬高性心肌梗死)患者682例.分析不同年龄段AMI患者吸烟、高脂血症、2型糖尿病及高血压等传统危险因素的差异.结果最终613例患者进入本研究,其中青年组43例,中年组216例,老年组234例,老老年组120例.(1)青年组与中年组、老年组及老老年组相比,吸烟与高脂血症比例均显著升高(P＜ 0.0125或＜0.001)；中年组与老年组相比,吸烟比例显著升高(P＜ 0.001),两组高脂血症比例比较差异无统计学意义(P＞0.0125)；中年组与老老年组相比,吸烟与高脂血症比例均明显升高(P＜ 0.001或＜0.0125).(2)正在吸烟的AMI患者发病年龄为(56.84±13.00)岁,从不吸烟的AMI患者发病年龄为(74.29±10.57)岁,两者比较差异有统计学意义(P＜0.01).合并高脂血症的AMI患者发病年龄为(62.92±15.04)岁,未合并高脂血症的AMI患者发病年龄为(68.63±13.93)岁,两者比较差异有统计学意义(P＜0.01).结论吸烟及高脂血症,尤其吸烟是中青年AMI患者发病的重要危险因素,对于AMI发病年龄明显提前起到重要促进作用,而积极戒烟及控制血脂有望对减少中青年AMI发病率发挥积极意义.
목적 분석불동년령단급성심기경사(AMI)환자합병전통위험인소적현상,진이탐토불동위험인소대AMI발병년령변화적영향.방법 기록2003년10월지2010년10월수치적AMI(포괄ST단태고성심기경사급비ST단태고성심기경사)환자682례.분석불동년령단AMI환자흡연、고지혈증、2형당뇨병급고혈압등전통위험인소적차이.결과 최종613례환자진입본연구,기중청년조43례,중년조216례,노년조234례,로노년조120례.(1)청년조여중년조、노년조급로노년조상비,흡연여고지혈증비례균현저승고(P＜ 0.0125혹＜0.001)；중년조여노년조상비,흡연비례현저승고(P＜ 0.001),량조고지혈증비례비교차이무통계학의의(P＞0.0125)；중년조여로노년조상비,흡연여고지혈증비례균명현승고(P＜ 0.001혹＜0.0125).(2)정재흡연적AMI환자발병년령위(56.84±13.00)세,종불흡연적AMI환자발병년령위(74.29±10.57)세,량자비교차이유통계학의의(P＜0.01).합병고지혈증적AMI환자발병년령위(62.92±15.04)세,미합병고지혈증적AMI환자발병년령위(68.63±13.93)세,량자비교차이유통계학의의(P＜0.01).결론 흡연급고지혈증,우기흡연시중청년AMI환자발병적중요위험인소,대우AMI발병년령명현제전기도중요촉진작용,이적겁계연급공제혈지유망대감소중청년AMI발병솔발휘적겁의의.
Objective To analyze the current situation of traditional risk factors in acute myocardial infarction (AMI) patients with different age,and to explore the impact of different risk factors on AMI.Methods The personal clinical characteristics of 682 hospitalized AMI patients in CCU were recorded from October 2003 to October 2010 with a retrospective cohort study.The effect of smoking,hyperlipidemia,diabetes and hypertension on AMI was observed.Results Six hundred and thirteen patients were enrolled in the end,43 cases in young group,216 cases in middle age group,234 cases in older age group,120cases in old-old age group.(1) Compared with that in middle age group,older age group and old-old age group,the ratio of smoking and hyperlipidemia in young group was significantly higher(P ＜ 0.0125 or ＜ 0.001).The ratio of smoking in middle age group was significantly higher than that in older age group(P ＜ 0.001),and the ratio of hyperlipidemia between two groups had no significant difference (P ＞ 0.0125).The ratio of smoking and hyperlipidemia was significantly higher in middle age group compared with that in old-old age group(P＜0.001 or ＜ 0.0125).(2) The average age in smoking patients with AMI was (56.84 ± 13.00) years,which was significantly younger than that in non-smoking patients[(74.29 ± 10.57) years] (P ＜ 0.01).The average age in patients with hyperlipidemia suffering from AMI was significantly younger than that in patients with normal lipid level patients [(62.92 ± 15.04) years vs.(68.63 ± 13.93) years] (P ＜ 0.01).Conclusions Smoking and hyperlipidemia,especially smoking plays an important role in inducing AMI in young and middle age.Smoking cessation and lipid-lowering therapy is vital for reducing the occurrence of AMI in young and middle age.