本文選題：青年人 + 急性心肌梗死　； 參考：《新疆醫(yī)科大學》2013年碩士論文

【摘要】：目的：探討青年人急性心肌梗死(acute myocardial infarction, AMI)的危險因素、臨床表現(xiàn)和冠狀動脈病變特點。 方法：回顧性分析2009年8月至2012年10月在新疆醫(yī)科大學第五附屬醫(yī)院心內(nèi)科住院診斷為AMI并行冠狀動脈造影檢查的青年患者70例、老年患者80例，并選取同期住院排除冠心病診斷并行冠狀動脈造影檢查的青年患者70例。收集三組患者吸煙史、早發(fā)冠心病家族史、高血壓病病史、2型糖尿病病史、臨床表現(xiàn)、輔助檢查結(jié)果等臨床資料，從而總結(jié)出青年人AMI的臨床特點。 結(jié)果：①青年AMI組FG、TC、TG、LDL-C、吸煙、高血壓病、2型糖尿病、早發(fā)冠心病家族史與對照組比較差異具有統(tǒng)計學意義(P＜0.05)。logistic回歸分析顯示：高血壓病(OR=5.795)、2型糖尿病(OR=4.528)、早發(fā)冠心病家族史(OR=2.892)、吸煙(OR=2.136)均為青年AMI的獨立危險因素。②青年AMI患者前驅(qū)癥狀、典型胸痛癥狀與老年AMI組有顯著性差異(P＜0.01)。兩組AMI患者梗死類型均以急性ST段抬高型心肌梗死(segment elevation myocardial infarction,STEMI)為主，差異無統(tǒng)計學意義(P＞0.05)。③青年AMI組冠狀動脈造影正常者占有一定比例(8.57%);單支病變、三支病變、彌漫性病變及側(cè)枝循環(huán)情況與老年AMI組比較均有統(tǒng)計學差異(P 0.05)。 結(jié)論：青年AMI者的獨立危險因素依次為高血壓病、2型糖尿病、早發(fā)冠心病家族史、吸煙；臨床表現(xiàn)為:前驅(qū)癥狀少，常有典型胸痛癥狀，心肌梗死類型以ST段抬高型心肌梗死(STEMI)為主；冠狀動脈造影結(jié)果正常者占一定比例，，并以單支病變?yōu)橹鳌?br/>[Abstract]:Objective: to investigate the risk factors, clinical manifestations and coronary artery disease characteristics of young patients with acute myocardial infarction (acute myocardial infarction,). Methods: from August 2009 to October 2012, 70 young patients with AMI and 80 elderly patients with AMI in Department of Cardiology, Fifth affiliated Hospital of Xinjiang Medical University, were analyzed retrospectively. A total of 70 young patients who excluded coronary heart disease and underwent coronary angiography in the same period were selected. The history of smoking, the family history of early coronary heart disease, the history of hypertension and the history of type 2 diabetes mellitus were collected, and the clinical features of AMI in young people were summarized. Results in young AMI group, FGG TCU TGG LDL-C, smoking, hypertension and type 2 diabetes mellitus were observed. Logistic regression analysis showed that hypertension (OR5.795) type 2 diabetes mellitus (OR4.528), familial history of early coronary heart disease (OR2.892), smoking (OR2.136) were independent risk factors of young AMI. Prodromal symptoms in AMI patients, There was significant difference between the typical chest pain symptom and the elderly AMI group (P < 0.01). The infarct type of acute ST-segment elevation myocardial infarction (segment elevation myocardial) was the main type in the two groups (P > 0. 05). There was no significant difference (P > 0. 05) in the proportion of patients with normal coronary artery angiography (8. 57%), single vessel lesion and three vessel lesion in young AMI group (P > 0. 05), and there was no significant difference between the two groups (P > 0. 05). There were significant differences in diffuse lesion and collateral circulation between the elderly AMI group and the elderly group (P 0.05). Conclusion: the independent risk factors of young patients with AMI are hypertension type 2 diabetes mellitus, early family history of coronary heart disease and smoking. St segment elevation myocardial infarction (STEMI) was the main type of myocardial infarction, and normal coronary angiography was the most common type of myocardial infarction.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R542.22

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