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年轻急性心肌梗死患者冠状动脉病变特征及危险因素的临床研究

Clinical Study on Characteristics and Risk Factors of Coronary Artery Lesions in Young Patients with Acute Myocardial Infarction.

作者信息

Liu Hua, Zhang Jiangang, Ma Zengcai, Xu Zesheng

机构信息

Tianjin Medical University, Tianjin, China.

Department of Cardiology, Cangzhou Central Hospital of Tianjin Medical University, Tianjin, China.

出版信息

Evid Based Complement Alternat Med. 2021 Oct 4;2021:5716410. doi: 10.1155/2021/5716410. eCollection 2021.

Abstract

Epidemiological evidence suggests that the incidence of acute myocardial infarction (AMI) among people under 40 years of age has an increasing trend in recent years. Smoking, hypertension, diabetes mellitus, family history, and gender (male) are considered as classic risk factors for CHD, but the pathogenesis of CHD in young people is not exactly the same. Moreover, the relationship between the pattern of coronary artery disease and risk factors in young patients with acute myocardial infarction is inconclusive. In this study, we retrospectively studied the clinical data of 150 AMI patients treated in our hospital from January 2020 to May 2021. The patients were divided into the young group and elderly group according to the difference in age. The number of coronary artery lesions, the degree of coronary artery stenosis, the distribution dominance typing, the position of the lesions, and the presence of collateral circulation were observed and compared between the two groups. Multivariate logistic regression analysis was used to investigate the risk factors affecting coronary artery lesions in young patients with AMI. The results showed that the number of coronary lesions in young patients with AMI was mainly single-vessel, and the dominant type of distribution was mainly right dominant type. The stenosis degree is lighter than that of elderly patients, and the incidence of collateral circulation is lower than that of elderly patients, but the position of the lesions has no obvious regular. Smoking, staying up late, HDL-C, and LDL-C/ApoB were independent factors affecting the number of coronary artery lesions, and the changes of HDL-C and LDL-C/ApoB had an important influence on the degree of coronary stenosis in young patients. This provides a new idea for clinical treatment.

摘要

流行病学证据表明,近年来40岁以下人群急性心肌梗死(AMI)的发病率呈上升趋势。吸烟、高血压、糖尿病、家族史和性别(男性)被认为是冠心病的经典危险因素,但年轻人冠心病的发病机制并不完全相同。此外,急性心肌梗死青年患者的冠状动脉疾病模式与危险因素之间的关系尚无定论。在本研究中,我们回顾性分析了2020年1月至2021年5月在我院接受治疗的150例AMI患者的临床资料。根据年龄差异将患者分为青年组和老年组。观察并比较两组患者的冠状动脉病变数量、冠状动脉狭窄程度、分布优势分型、病变部位及侧支循环情况。采用多因素logistic回归分析探讨影响急性心肌梗死青年患者冠状动脉病变的危险因素。结果显示,急性心肌梗死青年患者的冠状动脉病变数量以单支血管为主,分布优势类型以右优势型为主。狭窄程度较老年患者轻,侧支循环发生率低于老年患者,但病变部位无明显规律。吸烟、熬夜、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇/载脂蛋白B(LDL-C/ApoB)是影响冠状动脉病变数量的独立因素,HDL-C和LDL-C/ApoB的变化对青年患者冠状动脉狭窄程度有重要影响。这为临床治疗提供了新思路。

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[Clinical characteristics and prognosis of myocardial infarction with non-obstructive coronary arteries].
Zhonghua Nei Ke Za Zhi. 2020 Jul 1;59(7):546-549. doi: 10.3760/cma.j.cn112138-20190726-00521.

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