目的： 分析早发急性心肌梗死（PMI）患者可能的临床危险因素和冠状动脉病变特点。方法： 选取我院195例确诊急性心肌梗死患者，根据年龄分为PMI组115例和晚发急性心肌梗死组80例，同时选择经冠状动脉造影检查排除冠心病者75例为对照组。分别比较PMI组与对照组、晚发急性心肌梗死组在年龄、吸烟史、早发冠心病家族史、高血压病史、2型糖尿病病史、体重指数（BMI）、血清尿酸、空腹血糖、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）及高密度脂蛋白胆固醇（HDL-C）之间的差异。分析PMI患者可能的危险因素和其冠脉病变特点。结果： 与对照组相比，PMI组在吸烟史、早发冠心病家族史、高血压病史比率及BMI、血清尿酸、TC、TG、LDL-C水平均高于对照组，HDL-C水平低于对照组，差异具有统计学意义（P<0.05）。PMI组在吸烟、合并早发冠心病家族史比率及血清尿酸、TC、TG、LDL-C水平均高于晚发急性心肌梗死组，合并高血压病、合并2型糖尿病的比率、平均年龄及空腹血糖水平均低于晚发急性心肌梗死组，差异具有统计学意义（P<0.05）。PMI组患者以单支（39.1%）和双支病变（40.0%）为主，受累的单支血管病变以左前降支为主（65.2%），其次受累的单支血管分别为右冠状动脉（47.8%）和回旋支（32.2%）。应用Logistic回归模型进行多因素分析显示，早发冠心病家族史、高TG血症及吸烟史是PMI的危险因素（P<0.05）。结论： 早发冠心病家族史、高TG血症及吸烟史可能是本地区PMI的危险因素。PMI冠脉病变以单支、双支病变为主，PMI冠脉病变更容易行急诊血运重建。

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