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目的:通过病例对照研究探讨35岁以下青年急性冠脉综合征(ACS)的危险因素。方法:选择我院就诊的18～35岁急性心肌梗死和不稳定型心绞痛患者作为ACS组,同期就诊、年龄和性别匹配的非ACS患者作为对照组,记录两组的临床特征,包括年龄、性别、体质量指数(BMI)、吸烟史、饮酒史、是否并发高血压病、糖尿病和血脂异常、ACS类型、冠脉病变情况,然后通过单因素和多因素分析判断青年ACS的危险因素。结果:两组各入选338例患者,单因素分析表明ACS组吸烟、高血压病、糖尿病、血脂异常、肥胖、睡眠缺乏者显著高于非ACS组,进一步多因素分析表明吸烟、高血压病、糖尿病、血脂异常、肥胖、睡眠缺乏是青年ACS发病的独立危险因素,诱发青年ACS的OR值分别是2.0、2.3、2.9、2.4、3.2和1.5。结论:本研究表明除吸烟、高血压病、糖尿病、血脂异常、肥胖等因素外,睡眠缺乏也是35岁以下青年ACS患者的独立危险因素。
Objective: To explore the risk factors of acute coronary syndrome (ACS) in young people under 35 by case control study. Methods: The patients with acute myocardial infarction and unstable angina 18 to 35 years old who were treated in our hospital were enrolled in the ACS group. The patients of the same age, gender and age were selected as the control group. The clinical features, including age, sex , Body mass index (BMI), smoking history, drinking history, whether complicated with hypertension, diabetes and dyslipidemia, ACS type and coronary artery disease, and then to determine the risk factors of young ACS by univariate and multivariate analysis. Results: A total of 338 patients were enrolled in both groups. Univariate analysis showed that smoking, hypertension, diabetes, dyslipidemia, obesity and sleep deficits in ACS group were significantly higher than those in non-ACS group. Further multivariate analysis showed that smoking, hypertension, Diabetes mellitus, dyslipidemia, obesity and sleep deprivation were independent risk factors for ACS in young adults. The odds ratios (ORs) were 2.0, 2.3, 2.9, 2.4, 3.2 and 1.5 respectively. Conclusion: This study shows that sleep deprivation is an independent risk factor for ACS patients younger than 35 years old, except smoking, hypertension, diabetes, dyslipidemia, obesity and other factors.