老年急性心肌梗死患者临床特征的回顾性分析  

Clinical Characteristics of Acute Myocardial Infarction in the Senile Patients

作　　者：王静[1] 郑刚[1] 张德铭[1] 黄自平[1] 杜闻莹[1] 

机构地区：[1]天津市第三医院心内科,天津300250

出　　处：《中国医药导刊》2007年第2期116-118,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:了解老年急性心肌梗死(AMI)患者的临床特征。方法:我院心内科住院且资料完整的AMI病例507例,依据患者发病时实际年龄分为老年组(≥60岁)324例,对照组(＜60岁)183例。结果:(1)老年组女性AMI发病率高(37．35%比14．76%,P＜0．001);发病前老年组合并高血压(57．40%比43．17%,P＜0．005)、糖尿病(28．30%比15．30%, P＜0．001)、脑卒中(16．98%比4．92%,P＜0．001)、陈旧性心肌梗死(18．21%比7．10%,P＜0．001)、慢性阻塞性肺疾病(9．58%比1．64%,P＜0．001)、慢性肾功能不全(4．01%比0．55%,P＜0．05)多,有统计学差异。(2)老年组发病时有明显诱因者所占比例低(16．36%比30．60%,P＜0．001)、无痛性心肌梗死所占比例高(20．67%比8．20%,P＜0．001)、就诊时间晚[(13．58±3．47)比(6．53±1．68),P＜0．001]、早期接受再灌注治疗的少(37．35%比60．66%,P＜0．001)、接受β-阻滞剂治疗的少(54．94%比85．25%,P＜0．001),有统计学差异。(3)老年组住院期间梗死后心绞痛(28．09%比12．57%,P＜0．001)、心力衰竭(30．56%比10．38%,P＜0．001)、室性心动过速或心室颤动(16．05%比6．01%,P＜0．001)发生率高、病死率高(11．42%比3．28%,P＜0．001),有统计学差异。结论:老年AMI患者预后差。Objective： To investigate the clinical characteristics of acute myocardial infarction （AMI） in the senile patients. Methods： 507 patients with AMI in our hospital were divided into two groups according to their age, 324 cases were in senile group and 183 cases were in control group. Results： （1）Most of patients in the senile were female （37.35% vs 14.76%, P〈0.001）; in the senile group, the incidence of complications were significantly higher than those in control group, such as hypertension （57.40% vs 43.17%, P〈0.005）, diabetes meUitus （28.30% vs 15.30%, P〈0.001）, stroke （16.98% vs 4.92%, P〈0.001 ）, remote myocardial infarction（18.21% vs 7.10%, P〈0.001 ）, chronical obstructive pulmonary disease （9.58% vs 1.64%, P〈0.001 ） and chronical renal dysftmction （4.01% vs 0.55%, P〈0.05）. （2） In the senile group, the patients had obvious induccent were less than those in control group（ 16.36% vs 30.60%, P〈0.001）; the patients without chest pain were more （20.67% vs 8.20%, P〈0.001）： the ones late for hospitalizing were more [（13.58±3.47） vs （6.53± 1.68）, P〈0.001]; the ones receiving early- reperfusion therapy and β-blockers therapy were less （37.35% vs 60.66%, P〈0.001）. （3）In the senile group, the incidence of anginapectoris （28.09% vs 12.57%, P〈0.00I）, heartfailure （30.56% vs 10.38%, P〈0.001）, ventriculartachycardia/fibrillation （16.05% vs 6.01%, P〈0.001） and mortality rate （11.42% vs 3.28%, P〈0.001） were higher. Conclusion： The study suggests that the senile patients with AMI have worse clinical outcome.

关 键 词：老年 急性心肌梗死 临床特征 

分 类 号：R542.22[医药卫生—心血管疾病]