青年冠状动脉疾病的早期筛查和预防专家共识

doi:10.12114/j.issn.1007-9572.2025.0221

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青年冠状动脉疾病的早期筛查和预防专家共识

中国医药教育协会心血管内科专业委员会，中国医疗保健国际交流促进会心血管健康医学分会

通讯作者: 王炎，主任医师；丁虎，主任医师；杨德业，主任医师；李建平，主任医师

Expert Consensus on Early Screening and Prevention of Coronary Artery Disease in Young People

Cardiovascular Internal Medicine Professional Committee of China Medical Education Association，Cardiovascular Health Medicine Branch of China International Exchange and Promotion Association for Medical Care

Contact: WANG Yan，Chief physician；DING Hu，Chief physician；YANG Deye，Chief physician；LI Jianping，Chief physician

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摘要/Abstract

摘要： 青年人群（<45岁）冠状动脉疾病涵盖冠状动脉粥样硬化、痉挛、炎症、栓塞、自发性夹层、动脉瘤、物理化学性损伤、移位及引流异常等；其中，冠状动脉粥样硬化导致的缺血性心脏病（冠心病）最常见。本共识针对当前青年冠状动脉疾病的现状，重点阐述青年冠心病的流行病学、危险因素、诊断、筛查方法及预防策略，并特别强调早期筛查的重要性。建议对特定人群（如具有早发冠心病家族史、代谢综合征、慢性免疫介导的炎症性疾病患者及肾功能不全患者等）进行血脂、血糖、肾功能等常规检测，并结合基因检测（如家族性高胆固醇血症相关基因）进行定期评估。预防策略以生活方式干预为核心，包括低盐低脂饮食、规律运动、戒烟限酒、睡眠管理及防护空气污染。同时，推荐遵循指南进行血脂、血糖、高同型半胱氨酸及高血压的防控。此外，针对慢性肾脏病、慢性免疫介导炎症性疾病等疾病，需监测生物标志物并实施精准干预。共识指出，当前关于青年冠心病研究证据仍显不足，未来需加强在风险分层、筛查频率及治疗策略方面的循证医学研究，并通过多学科协作与公众教育，有效降低青年冠心病的发病率和疾病负担。

Abstract: Coronary artery disease （CAD）in young adults （aged<45 years old）encompasses a range of conditions affecting the coronary arteries，including atherosclerosis，vasospasm，inflammation，embolism，spontaneous dissection，aneurysm，physical or chemical injury，displacement，and abnormal drainage. Among these，ischemic heart disease （coronary heart disease，CHD）resulting from coronary atherosclerosis is the most prevalent. This consensus addresses the current landscape of CAD in young adults，focusing on the epidemiology，risk factors，diagnosis，screening methods，and preventive strategies for young-onset coronary CHD. It particularly emphasizes the critical importance of early screening. Routine testing—including lipid profiles，blood glucose levels，and renal function assessments—is recommended for specific high-risk populations （e.g.，individuals with a family history of premature CHD，metabolic syndrome，chronic immune-mediated inflammatory diseases，or impaired renal function）. Genetic testing （e.g.，for familial hypercholesterolemia-related genes）should also be incorporated for periodic risk assessment. Prevention strategies center on lifestyle interventions，such as adopting a low-salt，low-fat diet; engaging in regular physical activity; smoking cessation; limiting alcohol intake; maintaining good sleep hygiene; and minimizing exposure to air pollution. Additionally，guideline-directed management of dyslipidemia，hyperglycemia，hyperhomocysteinemia，and hypertension is recommended. For patients with comorbidities such as chronic kidney disease （CKD）or chronic immune-mediated inflammatory diseases，multidimensional biomarker monitoring and targeted interventions are essential. The consensus highlights that current evidence on young-onset CHD remains limited. Future research should strengthen the evidence regarding risk stratification，optimal screening frequency，and effective treatment strategies. Through multidisciplinary collaboration and enhanced public education，the goal is to reduce the incidence and disease burden of CHD in this young population.

中国医药教育协会心血管内科专业委员会, 中国医疗保健国际交流促进会心血管健康医学分会. 青年冠状动脉疾病的早期筛查和预防专家共识[J]. 中国全科医学. DOI: 10.12114/j.issn.1007-9572.2025.0221.

Cardiovascular Internal Medicine Professional Committee of China Medical Education Association, Cardiovascular Health Medicine Branch of China International Exchange and Promotion Association for Medical Care. Expert Consensus on Early Screening and Prevention of Coronary Artery Disease in Young People[J]. Chinese General Practice, DOI: 10.12114/j.issn.1007-9572.2025.0221.