摘 要：目的 探討30岁以下急性ST段抬高型心肌梗死患者的临床特点。方法 选择首次发病的STEMI患者51例，按年龄分青年组17例（年龄18～30岁），对照组34例（年龄≥31岁），对两组人群常见的危险因素、临床特点、冠状动脉病变特点以及发病30 d内主要不良心血管事件发生率进行对比分析。结果 ①青年组中男性、吸烟、合并高血压、合并高脂血症患者比例明显高于对照组，差异有统计学意义（P<0.05）;青年组体质量指数、左心室射血分数以及血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平明显高于对照组，总胆红素水平低于对照组，差异有统计学意义（P<0.05）;②青年组“罪犯血管”病变类型以单支病变、A型病变为主，对照组多为三支病变、分叉病变、C型病变，差异有统计学意义（P<0.05）;③青年组发病30 d内梗死后心绞痛、心力衰竭、恶性心律失常的发生率明显低于对照组，差异有统计学意义（P<0.05）。结论 男性、吸烟、合并高血压、合并高脂血症是30岁以下STEMI患者突出的危险因素，其冠脉病变多为单支、A型病变，发病30 d内临床预后良好。
关键词：青年;心肌梗死;危险因素;冠脉造影
中图分类号：R542.22 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.05.026
文章编号：1006-1959（2018）05-0081-03
Clinical Characteristics of Acute ST-segment Elevation Myocardial Infarction under 30 Years of Age
ZHAI Gong-wei，ZHAO Pei-hua，HUA Yan
（Department of CCU，Jinghai District Hospital，Tianjin 301600，China）
Abstract：Objective To investigate the clinical characteristics of acute ST segment elevation myocardial infarction（AMI）patients under 30 years of age.Methods 51 STEMI patients with first onset were divided by age youth group of 17 cases（age 18～30），the control group of 34 cases（aged≥31 years），risk factors，two groups of common clinical features，characteristics of coronary artery lesions and within 30 d of onset of major adverse cardiovascular events incidence were compared analysis.Results ①The youth group in male，smoking，hypertension，and hyperlipidemia patients were significantly higher than the control group，the difference was statistically significant（P<0.05）;youth group，body mass index，left ventricular ejection fraction，serum total cholesterol，triglyceride，low density lipoprotein cholesterol levels were significantly higher than the control group，the total bilirubin level compared with the control group， the difference was statistically significant（P<0.05）.②In the young group，the types of"criminals blood vessels"were mainly single vessel lesion and A type lesion.The control group had three branches，bifurcation lesions and C lesions.The difference was statistically significant（P<0.05）.③The incidence of angina pectoris， heart failure and malignant arrhythmia in the young group was significantly lower than that in the control group within 30 d after onset，and the difference was statistically significant（P<0.05）.Conclusion Men， smoking，hypertension and hyperlipidemia are prominent risk factors for STEMI patients under 30 years old.Their coronary lesions are mostly single and A lesions，and the prognosis is good within 30 d.