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目的探讨45岁以下冠心病患者的临床和冠状动脉造影特点。方法选择2006年4月—2010年5月在本院住院治疗的冠心病患者1 795例,从中选出45岁以下冠心病的所有患者175例作为A组。选择2007年4月—2009年4月在本院住院治疗的冠心病患者898例,采取整群抽样方法从中选出60岁以上的冠心病患者464例作为B组,进行对比分析,对45岁以下冠心病的临床以及冠状动脉造影的特点进行分析总结。结果 A组男性、吸烟、吸安纳咖、血脂异常、急性心肌梗死、冠脉造影和冠心病家族史比例均明显高于B组(P<0.05或P<0.01),而A组高血压病、糖尿病均低于B组(P<0.01)。A组患者单支病变高于B组(P<0.01),A组单支病变中前降支有50例(87.7%);A组三支病变、双支病变、右冠脉、旋支病变及侧支循环建立比例低于B组(P<0.05或P<0.01);左主干病变、前降支病变及冠脉狭窄程度两组间无统计学意义。无意义病变A组高于B组(P<0.01)。结论 45岁以下冠心病患者多数以急性心肌梗死就诊;与男性、吸烟、体力活动少、处于高度紧张和工作压力大、血脂异常及有冠心病家族史者关系密切,冠状动脉造影特点多数为局限性病变;约一半为单支病变,且以前降支单支病变为主;部分患者冠脉造影未见有意义病变,且以心肌梗死为主;2支及3支病变、右冠脉及旋支病变、侧支循环建立比例低于60岁以上冠心病患者;冠脉狭窄程度及前降支病变、左主干病变与60岁以上冠心病患者相似。
Objective To investigate the clinical and coronary angiographic features of patients under 45 years of age with coronary heart disease. Methods A total of 1 795 CHD patients hospitalized in our hospital from April 2006 to May 2010 were selected. All 175 patients with coronary heart disease under 45 years old were selected as A group. A total of 898 coronary heart disease patients hospitalized in our hospital from April 2007 to April 2009 were selected and 464 coronary heart disease patients over the age of 60 were selected as the B group by cluster sampling method. The following clinical features of coronary heart disease and coronary angiography were analyzed and summarized. Results The proportions of male, smoking, inhaling sodium, dyslipidemia, acute myocardial infarction, coronary angiography and family history of coronary heart disease in group A were significantly higher than those in group B (P <0.05 or P <0.01) , Diabetes were lower than the B group (P <0.01). In group A, the single-vessel lesion was higher in group B than in group B (P <0.01), while in group A, the number of anterior descending branches was 50 (87.7%) in group A; (P <0.05 or P <0.01). There was no significant difference between the two groups in left main artery lesion, anterior descending coronary artery and coronary artery stenosis. A group of non-meaningful lesions than in group B (P <0.01). Conclusions The majority of coronary heart disease patients under 45 years of age are treated with acute myocardial infarction. Compared with men, there is less smoking, less physical activity, close high stress and working pressure, dyslipidemia and family history of coronary heart disease. Most coronary angiography features are limited About half of the lesions were single and the lesions of the single branch of the anterior descending branch were predominant. There were no significant lesions in coronary angiography in some patients and the main ones were myocardial infarction. The 2 and 3 lesions, right coronary artery and spinous Branch disease, collateral circulation to establish the proportion of patients with coronary heart disease lower than 60 years of age; coronary stenosis and anterior descending coronary artery disease, left main disease and coronary heart disease patients over the age of 60 were similar.