中青年女性患者急性心肌梗死临床特点分析
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摘要
目的分析石河子地区中青年(20～60岁)女性患者急性心肌梗死主要危险因素、临床表现、冠脉病变特点、救治及预后情况。方法收集医院2015-2017年住院中青年女性(20～60岁)急性ST段抬高心肌梗死患者51例(心梗组)和同期在医院住院并行冠状动脉造影检查且冠脉无狭窄的中青年女性179例(正常组)的临床资料。结果心梗组患者来自农牧团场比例更高,心梗组患者吸烟/被动吸烟、高盐高胆固醇饮食、高血压、糖尿病、血脂代谢异常及冠心病家族史者比例高于正常组,差异有统计学意义(P <0. 05); Logistic多因素分析显示高血压病史、糖尿病病史、血脂代谢异常史、空腹血糖、低密度脂蛋白胆固醇是心肌梗死患者的独立危险因素,高密度脂蛋白胆固醇是心肌梗死的保护因素。结论高血压、糖尿病、血脂代谢异常病史、空腹血糖、低密度脂蛋白胆固醇是石河子地区中青年女性患者急性心肌梗死的独立危险因素,高密度脂蛋白胆固醇是保护因素;本地区中青年女性急性ST段抬高性心肌梗死病变血管以单支和三支为主,梗塞血管多见于前降支。
Objective To analyze the main risk factors,clinical manifestations,characteristics of coronary artery lesions,treatment and prognosis of acute myocardial infarction in young and middle-aged women( 20-60 years old) in Shihezi area. Methods The clinical data of 51 young and middle-aged women( 20-60 years old) with acute ST-segment elevation myocardial infarction( ST-segment elevation myocardial infarction group) admitted to hospital from 2015 to 2017 and 179 young and middle-aged women( normal group) admitted to hospital with coronary angiography without coronary artery stenosis at the same time were collected. Results The proportion of people from farming and pastoral areas was higher in the myocardial infarction group. The proportion of active or passive smoking,high salt and cholesterol diet,hypertension,diabetes mellitus,dyslipidemia and family history of coronary heart disease in patients with myocardial infarction was higher than that in normal group( P < 0. 05). Logistic multivariate analysis showed that hypertension,diabetes mellitus,dyslipidemia,fasting blood sugar and low density lipoprotein cholesterol were independent risk factors for myocardial infarction. High density lipoprotein cholesterol is a protective factor for myocardial infarction. Conclusion Hypertension,diabetes mellitus,history of abnormal lipid metabolism,fasting blood sugar and low density lipoprotein cholesterol are independent risk factors for acute myocardial infarction in young and middle-aged women in Shihezi area. High density lipoprotein cholesterol is a protective factor. Acute ST-segment elevation myocardial infarction in young and middle-aged women in this region is characterized by single and three vessels,and most of the infarcted vessels are in the anterior descending artery.
Objective To analyze the main risk factors,clinical manifestations,characteristics of coronary artery lesions,treatment and prognosis of acute myocardial infarction in young and middle-aged women( 20-60 years old) in Shihezi area. Methods The clinical data of 51 young and middle-aged women( 20-60 years old) with acute ST-segment elevation myocardial infarction( ST-segment elevation myocardial infarction group) admitted to hospital from 2015 to 2017 and 179 young and middle-aged women( normal group) admitted to hospital with coronary angiography without coronary artery stenosis at the same time were collected. Results The proportion of people from farming and pastoral areas was higher in the myocardial infarction group. The proportion of active or passive smoking,high salt and cholesterol diet,hypertension,diabetes mellitus,dyslipidemia and family history of coronary heart disease in patients with myocardial infarction was higher than that in normal group( P < 0. 05). Logistic multivariate analysis showed that hypertension,diabetes mellitus,dyslipidemia,fasting blood sugar and low density lipoprotein cholesterol were independent risk factors for myocardial infarction. High density lipoprotein cholesterol is a protective factor for myocardial infarction. Conclusion Hypertension,diabetes mellitus,history of abnormal lipid metabolism,fasting blood sugar and low density lipoprotein cholesterol are independent risk factors for acute myocardial infarction in young and middle-aged women in Shihezi area. High density lipoprotein cholesterol is a protective factor. Acute ST-segment elevation myocardial infarction in young and middle-aged women in this region is characterized by single and three vessels,and most of the infarcted vessels are in the anterior descending artery.
引文
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[2] Whayne TF Jr,Mukherjee D. Effect of postmenopausM estrogen replacement on the concentrations and metabolism of plasma lipoproteints[J]. Curr Opin Cardiol,2015,30(4):432-438.
[3] Mentias A,Hill E,Barakat AF,et al. An alarming trend:Change in the risk profile of patients with ST elevation myocardial infarctionover the last two decades[J]. Int J Cardiol,2017,12(248):69-72.
[4] Vernon ST,Coffey S,Bhindi R,et al. Increasing proportion of ST elevation myocardial infarction patients with coronary atherosclerosis poorly explained by standard modifiable risk factors[J]. Eur J Prev Cardiol,2017,24(17):1824-1830.
[5] Gleerup HB,Dahm CC,Thim T,et al. Smoking is the dominating modifiable risk factor in younger patients with STEMI.[J]. Eur Heart J Acute Cardiovasc Care,2018,8(2):1041-1045.
[6] Appelman Y,van Rijn BB,Ten Haaf ME,et al. Sex differences in cardiovascular risk factors and disease prevention[J]. Atherosclerosis,2015,241(1):211-218.
[7] Yano M,Miura S,Shiga Y,et al. Association between smoking habits and severity of coronary stenosis as assessed by coronary computed tomography angiography[J]. Heart Vessels,2016,31(7):1061-1068.
[8]马冠生,孔林芝,栾德春,等.中国居民吸烟行为的现状分析[J].中国慢性病预防和控制,2015,13(5):195-199.
[9]马先富,王建勋,马海燕,等.杭州市农村居民归因于吸烟的疾病负担研究[J].中国农村卫生事业管理,2018,38(7):873-877.
[10]南奕,王立立,陈心悦.中国女性对吸烟和二手烟危害认知及二手烟暴露情况分析[J].中国慢性病预防与控制,2015,23(6):443-445. DOI:10. 16386/j. cjpccd. issn. 1004-6194. 2015. 06.011.
[11]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2014》概要[J].中国循环杂志,2015,30(7):617-622. DOI:10. 3969/j.issn. 1000-3614. 2015. 07. 001.
[12]何建辉,蔡乐,龙婷.云南省某农村地区体重相关指数分布与心血管疾病的关系[J].昆明医科大学学报,2016,37(5):13-16.DOI:10. 3969/j. issn. 1003-4706. 2016. 05. 004.