CAJ | 학술논문

目的：探讨青年急性ST段抬高型心肌梗死( STEMI)的临床特点以及冠状动脉病变特征。方法：选择首次发病的STEMI患者112例,按年龄分青年组43例(年龄18~44岁)、老年组69例(年龄≥60岁),对两组患者间的主要危险因素,临床特点和冠状动脉病变特征进行对比分析。结果：青年组患者腹型肥胖、吸烟史、饮酒史、早发冠心病家族史及血脂异常程度均高于老年组(P<0.05)；青年组患者以男性为主。青年组患者发病前多伴有过度劳累、情绪异常、暴食酗酒等诱发因素(P<0.05)。青年组患者多为前降支病变(P<0.05),单支冠脉病变比例明显高于老年冠心病组(P<0.05),ACC/AHA冠脉病变分类低危组占多数。结论：患者腹型肥胖、吸烟、饮酒、早发心血管疾病家族史及血脂异常,主要是青年STEMI患者的危险因素,青年组发病前多伴有过度劳累、情绪异常、暴食酗酒等诱发因素。冠状动脉造影示青年组以单支血管病变为主,大多累及前降支近段,病变多为低危组。
목적：탐토청년급성ST단태고형심기경사( STEMI)적림상특점이급관상동맥병변특정。방법：선택수차발병적STEMI환자112례,안년령분청년조43례(년령18~44세)、노년조69례(년령≥60세),대량조환자간적주요위험인소,림상특점화관상동맥병변특정진행대비분석。결과：청년조환자복형비반、흡연사、음주사、조발관심병가족사급혈지이상정도균고우노년조(P<0.05)；청년조환자이남성위주。청년조환자발병전다반유과도로루、정서이상、폭식후주등유발인소(P<0.05)。청년조환자다위전강지병변(P<0.05),단지관맥병변비례명현고우노년관심병조(P<0.05),ACC/AHA관맥병변분류저위조점다수。결론：환자복형비반、흡연、음주、조발심혈관질병가족사급혈지이상,주요시청년STEMI환자적위험인소,청년조발병전다반유과도로루、정서이상、폭식후주등유발인소。관상동맥조영시청년조이단지혈관병변위주,대다루급전강지근단,병변다위저위조。
Objective:To analyze clinical characteristics and coronary artery disease characteristics in young patients with acute ST-elevation myocardial infarction ( STEMI) . Methods:112 patients with first-episode STEMI were selected and divided into young group (43 cases, 18-44 years old) and elderly group (69 cases, over than 60 years old). The main risk factors, clinical characteris-tics and coronary artery disease characteristics of the two groups were analyzed and compared. Results:The abdominal obesity, smok-ing history, drinking history, family history of premature coronary heart disease and dyslipidemia degree of young group were higher than those of elderly group (P<0. 05). Male was dominated in young group. Compared with the elderly patients, the causative factors of excessive fatigue, mood disorders, over eating and drinking were more frequently found among the young patients (P<0. 05). The young patients showed a higher incidence of the anterior descending branch lesion (P<0. 05), and their one-vessel disease rates were obviously higher than those of elderly patients (P<0. 05). Conclusions:The abdominal obesity, smoking, drinking, family history of premature coronary heart disease and dyslipidemia are the major risk factors for the young patients with acute STEMI. The causative factors of excessive fatigue, mood disorders, over eating and drinking are more frequently found among the young patients. Coronary ar-teriography shows that the young patients show the higher incidence of one-vessel disease, mainly involving the proximal anterior de-scending branch, and the lesions are in the low-risk group.