目的 比较青年与老年急性心肌梗死（acute myocardial infarction，AMI）发病的临床特征，探讨青年AMI发病有无季节性特点。
Abstract
Objective To investigate whether there is a seasonal difference in the onset of acute myocardial infarction (AMI) in young patients, compared with older patients. Methods The study group comprised 81 young (aged≤40 years) and 678 older (aged≥50 years) patients with AMI from 2004 to 2008. AMI incidence of the season and the relationship with the event were analyzed by Logistic regression. AMI and the extent of coronary artery disease and coronary heart disease risk factors were analyzed by Pearson's chi-square test. Results In young patients, the prevalence of the onset of AMI events was significantly higher in summer (from June to August) than in winter (from November to March) (odds ratio =4.004, P=0.031). The incidence rate in young women decreased significantly compared with that in elderly group (3.70% vs 35.84%).Vascular lesion alone in the young group was significantly higher than that in the elderly group (48.15% vs 36.99%). Hypertension was found in 44.44%, diabetes in 3.7%, elevated serum TC and TG in 29.63% and 48.15% ,and smoking history in 74.07% of young patients. Conclusions There is a seasonal difference in the onset of AMI events, with an increase in the prevalence during the summer months in young patients.
关键词
急性心肌梗死 /
发病季节 /
青年
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
［1］ Manfredini R, Boari B, Bressan S, et al. Influence of circadian rhythm on mortality after myocardial infarction: data from a prospective cohort of emergency calls ［J］. Am J Emerg Med，2004，22(7):555-559.
[2] Arntz H R, Willich S N, Schreiber C, et al. Diurnal, weekly and seasonal variation of sudden death. Population-based analysis of 24,061 consecutive cases ［J］. Eur Heart J，2000，21(4):315-320.
[3] Kriszbacher I, Boncz I, Koppan M, et al. Seasonal variations in the occurrence of acute myocardial infarction in Hungary between 2000 and 2004 ［J］. Int J Cardiol，2008，129(2):251-254.
[4] Thompson D R, Blandford R L, Sutton T W, et al. Time of onset of chest pain in acute myocardial infarction ［J］. Int J Cardiol，1985，7(2):139-148.
[5] Muller J E, Stone P H, Turi Z G, et al. Circadian variation in the frequency of onset of acute myocardial infarction ［J］. N Engl J Med，1985，313(21):1315-1322.
[6] Douglas A S, Dunnigan M G, Allan T M, et al. Seasonal variation in coronary heart disease in Scotland ［J］. J Epidemiol Community Health，1995，49(6):575-582.
[7] Freeman J W, McGlashan N D ，Loughhead M G. Temperature and the incidence of acute myocardial infarction in a temperate climate ［J］. Am Heart J，1976，92(3):405-407.
[8] Heyer H E, Teng H C ，Barris W. The increased frequency of acute myocardial infarction during summer months in a warm climate; a study of 1,386 cases from Dallas, Texas ［J］. Am Heart J，1953，45(5):741-748.
[9] The Joint International Society and Federation of Cardiology/World Health Organization Task Force on Standardization of Clinical Nomenclature.Nomenclature and criteria for diagnosis of ischemic heart disease( special port) ［J］. Circulation，1979, 59(3): 607- 609.
[10] 杨艳娟，任 雨，杨德江，等. 1951-2008年天津市气候季节变化特征及其对农业的影响 ［J］. 安徽农业科学，2010，38(10):5163-5165.
[11] Sheth T, Nair C, Muller J, et al. Increased winter mortality from acute myocardial infarction and stroke: the effect of age ［J］. J Am Coll Cardiol， 1999，33(7):1916-1919.
[12] Hermida R C, Calvo C, Ayala D E, et al. Seasonal variation of fibrinogen in dipper and nondipper hypertensive patients ［J］. Circulation，2003，108(9):1101-1106.
[13] Woodhouse P R, Khaw K T, Plummer M, et al. Seasonal variations of plasma fibrinogen and factor VII activity in the elderly: winter infections and death from cardiovascular disease ［J］. Lancet，1994，343(8895):435-439.
[14] Kawahara J, Sano H, Fukuzaki H, et al. Acute effects of exposure to cold on blood pressure, platelet function and sympathetic nervous activity in humans ［J］. Am J Hypertens，1989，2(9):724-726.
[15] Moschos N, Christoforaki M，Antonatos P. Seasonal distribution of acute myocardial infarction and its relation to acute infections in a mild climate ［J］. Int J Cardiol，2004，93(1):39-44.
[16] Fuster V, Badimon L, Badimon J J, et al. The pathogenesis of coronary artery disease and the acute coronary syndromes［J］. N Engl J Med，1992，326(5):310-318.
[17] Miyamoto S, Goto Y, Sumida H, et al. Risk factors and physical activity levels at the onset of acute myocardial infarction in young men ［J］. J Cardiol，2000，36(2):75-83.
[18] Cantin B, Despres J P, Lamarche B, et al. Association of fibrinogen and lipoprotein(a) as a coronary heart disease risk factor in men (The Quebec Cardiovascular Study) ［J］. Am J Cardiol，2002，89(6):662-666.
[19] Hbejan K. Smoking effect on ischemic heart disease in young patients ［J］. Heart Views，2011，12(1):1-6.
[20] 曾 晖，刘新林. 口服摇头丸导致急性心肌梗死一例 ［J］. 武警医学，2010，21（12）: 1075-1076.［21］ 吴平生，张远慧，许工凯，等. 易损斑块及易损患者的新定义及危险分层 ［J］.中华心血管病杂志，2004，32（3）: 284-285.
PDF(410 KB)
