摘要
目的探讨青年女性急性心肌梗死（心梗）患者的临床危险因素及冠状动脉病变特点。方法回顾性分析2003年6月至2010年12月于我院住院诊断为急性心梗并行冠状动脉造影手术的青年女性（年龄≤44岁）共57例，选取同时期住院行冠状动脉造影除外冠心病诊断的青年女性60例作为对照组，并选取同期住院诊断为急性心梗的青年男性78例及老年女性80例为性别对照组和年龄对照组，观察体质指数、吸烟史、早发冠心病家族史、高血压病、2型糖尿病、高脂血症、血清尿酸、绝经、血脂、总胆红素、直接胆红素、血红蛋白、红细胞分布宽度、空腹血糖等与冠心病发病的关系。冠状动脉造影病变程度由病变支数表示。结果（1）与青年女性对照组比较，青年女性心梗组合并高血压病、高甘油三酯血症较多（P均〈0．05），空腹血糖、甘油三酯、尿酸水平较高（P〈0．05），高密度脂蛋白胆固醇、血红蛋白较低（P均〈0．05）。（2）logistic回归分析显示，与青年女性急性心梗独立相关的危险因素依次为高血压病（OR=23．187）、低血红蛋白血症（OR=1．010）及尿酸（OR=1．040）（P均〈0．05）。（3）青年女性心梗组的冠状动脉造影结果显示，正常6例，单支病变35例（61．40％），其中前降支病变26例，双支病变12例。青年女性心梗组中单支病变累及前降支的比例明显高于青年男性心梗组及老年女性心梗组（P均〈0．05）。结论高血压、低血红蛋白血症及尿酸是青年女性发生急性心梗的主要危险因素。青年女性冠状动脉病变特点以单支病变为主。
Objective To observe the clinical and coronary angiographic features of young women （ ≤44 years） with acute myocardial infarction （AMI）. Methods Clinic and coronary angiographie features were compared among 57 young women with AMI and 60 non-CHD young women, 78 young men with AMI and 80 elderly women with AMI were included, all patients were admitted to hospital from June 2003 to December 2010 and underwent coronary angiography. Body mass index （BMI）, smoking history, familial history of early coronary artery disease, essential hypertension, type 2 diabetes mellitus, hyperlipidemia, serum uric acid （UA） , menopause, lipids, total bilirubin （TBil） , direct bilirubin （DBil） , hemoglobin （Hb）, red cell distribution width （RDW）, fasting blood glucose （FBG） were measured. Results （1） Prevalence of essential hypertension, hypertriglyeeridemia and levels of fasting blood glucose, triglyceride, serum uric acid were significantly higher while high density lipoprotein cholesterol, and hemoglobin were significantly lower in young women with AMI group than in age-matched non-CHD control group （ all P 〈 0. 05 ）. （2） Logistic regression analysis showed that essential hypertension （OR = 23. 187 ）, lower hemoglobin level （ OR = 1. 010） and uric acid （ OR = 1. 040） were independent risk factors for young women with AMI （ all P 〈 0. 05 ）. （ 3 ） Coronary angiography revealed normal coronary finding in 6 cases, single- vessel disease in 35 cases （26 cases with left anterior descending artery disease） and two-vessel disease in 12 patients. The ratio of single vessel disease involved left anterior descending artery in young women was higher than that of young men and old women with AMI （all P 〈 0. 05 ） . Conclusion Essential hypertension, lower hemoglobin and uric acid are risk factors of young women with AMI. Single vessel coronary disease is the most common coronary angiographic feature of young women with AMI.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2012年第3期225-230,共6页
Chinese Journal of Cardiology
关键词
心肌梗死
青少年
危险因素
冠状血管造影术
Myocardial infarction
Adolescent
Risk factor
Coronary angiography
