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目的:探讨青年人急性心肌梗死(AMI)的临床特点及吸烟与其关系。方法:比较青年组(年龄≤45岁)与中老年组(年龄>45岁)AMI患者的临床特点及吸烟情况,检测青年组不同程度吸烟者的血细胞间黏附分子(ICAM)、血管细胞间黏附分子(VCAM)、CD40L水平。结果:与老年组比较,青年组患者缺乏高血压、血脂异常、糖尿病等危险因子,青年组所有男性均吸烟是最突出的特征;青年组主要是近期大量吸烟,而老年组主要是烟龄长,有的近年已戒烟。青年中吸烟量为10～19支/d者与吸烟量>20支/d者的ICAM水平分别为:35.74士5.05和43.76士8.46(P<0.05),VCAM水平为2.31士0.82与2.71士0.98(P>0.05),CD40L水平为2.65士0.85与2.13士0.73(P>0.05)。结论:青年人AMI常为急性起病,多为血栓性病变,吸烟是青年人AMI独立危险因子。吸烟可能通过激活淋巴细胞表答ICAM-1,而触发免疫及炎症反应,引起血管痉挛及血栓形成。
Objective: To investigate the clinical features of young acute myocardial infarction (AMI) and the relationship between smoking and smoking. Methods: The clinical features and smoking status of AMI patients in the youth group (aged ≤ 45 years) and middle-aged and elderly patients (age> 45 years) were compared. Intercellular adhesion molecule (ICAM), intercellular adhesion Molecular (VCAM), CD40L levels. Results: Compared with the elderly group, risk factors such as hypertension, dyslipidemia and diabetes were lacking in the youth group. Smoking was the most prominent feature among all the men in the youth group. The young group mainly smoked cigarettes in the near future, while the elderly group mainly had longer tobacco ages Some have quit smoking in recent years. The ICAM levels of young people with 10-19 cigarettes per day and those with smoking> 20 cigarettes per day were 35.74 ± 5.05 and 43.76 ± 8.46 (P <0.05), and the VCAM levels were 2.31 ± 0.82 and 2.71 ± 0.98 (P> 0.05). CD40L levels were 2.65 ± 0.85 and 2.13 ± 0.73 (P> 0.05). Conclusion: AMI is often acute onset in young people, mostly thrombotic diseases. Smoking is an independent risk factor for AMI in young people. Smoking may trigger immune and inflammatory responses by activating the lymphocyte response to ICAM-1, causing vasospasm and thrombosis.