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218例40岁以下心肌梗死患者的危险因素与冠状动脉形态(作者译)

[Riskfactors and coronary morphology in 218 patients with myocardial infarction under 40 years of age (author's transl)].

作者信息

Kovacsics H, Roskamm H, Stürzenhofecker P, Petersen J

出版信息

Z Kardiol. 1977 Dec;66(12):685-9.

PMID:602350
Abstract

With 218 postinfarction patients under 40 years of age who all underwent coronary angiography, the question in priority is: Can myocardial infarction in young age be characterized by special constellation of risk factors and by specific coronary morphology? Compared with results from literature the risk factors hypertension and diabetes seem to be of less importance than in older patients, smoking on the other hand seems to be more significant: 90.5% of postinfarction patients under 40 years of age were smoking regularly. Coronary angiography proved a pre-domination of 1-vessel disease: 72% showed 1-vessel, 17.9% 2-vessel and 10.1% 3-vessel disease. These findings and those from literature show that the majority of patients with myocardial infarction in young age have the following characteristics: In connection with the risk factor smoking the sclerotic coronary vessel process is developing rapidly, very often at a single spot. Since no longterm gradual occlusion process occurs, no prolonged period of angina pectoris precedes the infarction. There is no time for the development of an adequate collateral circulation; it follows that the infarction is a large one. After the acute infarction there is no angina pectoris.

摘要

对218例40岁以下的心肌梗死后患者均进行了冠状动脉造影,首要问题是:年轻时的心肌梗死是否具有特殊的危险因素组合及特定的冠状动脉形态特征?与文献结果相比,高血压和糖尿病等危险因素似乎不如老年患者中那么重要,另一方面,吸烟似乎更为显著:40岁以下心肌梗死后患者中有90.5%经常吸烟。冠状动脉造影显示单支血管病变占主导:72%表现为单支血管病变,17.9%为双支血管病变,10.1%为三支血管病变。这些发现以及文献中的发现表明,大多数年轻心肌梗死患者具有以下特征:与吸烟这一危险因素相关,冠状动脉硬化进程发展迅速,且常常发生在单个部位。由于不存在长期逐渐闭塞的过程,梗死前没有长时间的心绞痛发作。没有时间形成足够的侧支循环;因此梗死面积较大。急性梗死后无心绞痛发作。

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