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目的:结合新近发现的冠心病危险因素,总结青年人急性心肌梗死(AMI)的临床特点,并探讨其早发心肌梗死的可能机制。方法:回顾性对照分析青年组(≤40岁)和非青年组(≥50岁)AMI患者的危险因素和促发因素的分布及聚集状况,并行冠状动脉造影检查。结果:2组患者危险因素分布存在差异,青年组吸烟及家族史阳性率明显高于非青年组,新的危险因素中,青年组同型半胱氨酸(HCY)明显低于非青年组(P<0.05);青年组危险因素聚集率并不比非青年组高,但其发生AMI前多有明确的促发因素,且促发因素有聚集倾向。结论:青年人早发AMI可能与促发因素聚集有关,多种促发因素同时存在通过心肌缺血叠加效应导致动脉粥样硬化(AS)患者和非AS患者发生AMI。
OBJECTIVE: To summarize the clinical features of young acute myocardial infarction (AMI) and to explore its possible mechanism of premature myocardial infarction in combination with the newly discovered risk factors of coronary heart disease. Methods: Retrospective analysis of the distribution and aggregation of risk factors and predisposing factors in young patients (≤40 years old) and non-young adults (≥50 years old) with concurrent coronary angiography. Results: There were differences in the distribution of risk factors among the two groups. The positive rates of smoking and family history in youth group were significantly higher than those in non-youth group. Among the new risk factors, the homocysteine (HCY) in youth group was significantly lower than that in non-youth group <0.05). The aggregation rate of risk factors in youth group was no higher than that of non-youth group, but there were more definite trigger factors before AMI, and the predisposing factors had aggregation tendency. CONCLUSIONS: The AMI in young people may be related to the aggregation of pro-inflammatory factors. The combination of multiple pro-posed factors may cause AMI in patients with atherosclerosis (AS) and non-AS through myocardial ischemia superimposed effect.