高龄心肌梗死患者临床特点和住院期转归  

Clinical characteristics and in-hospital outcome of elderly patients with acute myocardial infarction

作　　者：李静[1] 华琦[1] 李博宇[1] 刘志[1] 范振兴[1] 邵强[1] 王艳玲[1] 

机构地区：[1]首都医科大学宣武医院心脏科,北京100053

出　　处：《中华老年多器官疾病杂志》2011年第1期40-43,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：北京市自然科学基金项目(7072032)~~

摘　　要：目的评价高龄心肌梗死患者临床特点、住院期间不良事件和病死率。方法收集初发急性ST段抬高心肌梗死患者974例临床资料,按照患者年龄分为高龄组(≥75岁,n=161)和对照组(<75岁,n=813),对两组临床特点(包括性别、年龄、吸烟、化验指标、并存疾患)、治疗方案、住院并发症和病死率进行比较。结果与对照组相比,高龄组女性以非典型症状为首发表现者更多,从症状发作到医院就诊所需时间更长,心、肾功能电差,存在较多的并患疾病。对照组患者血脂异常、吸烟的比例更高。高龄组服用β受体阻滞剂的比例明显低于对照组。高龄患者住院期间经历了更多的不良事件,包括心律失常、心源性休克、心力衰竭。高龄组住院病死率为18.4%,显著高于对照组患者(P<0.001)。结论高龄心肌梗死患者一般状态较差,多合并其他系统疾患,接受再灌注治疗的比例较低,住院期间不良事件发生率和住院病死率高。Objective To investigate clinical characteristics and in-hospital adverse events and mortality of elderly patients with acute myocardial infarction. Methods Totally, 974 patients with acute ST elevated myocardial infarction were divided into two groups： elderly group （≥75 years, n=161） and control group （〈75 years, n=813）. The patients＇ data, including clinical characteristics （gender, age, smoking, laboratory examinations, and comorbidities）, treatment protocols, in-hospital complications and mortality were compared between the two groups. Results Compared with control group, there were more female patients and more patients with atypical symptoms in elderly group. They had poorer heart and lung function and more comorbidities. Hyperlipidemia and smoking were more frequently observed in control group. There were less patients in elderly group who underwent reperfusion therapy and β blocker administration. Patients in elderly group experienced more adverse events, including arrhythmia, cardiogenic shock and heart failure. Patients in elderly group had significantly higher in-hospital mortality （18.4%） than control group （P〈0.001）. Conclusion Elderly myocardial infarction patients have poor general conditaion, more comorbidity, less reperfusion therapy, and higher adverse events incidences and mortalities.

关 键 词：心肌梗死 老年人 病死率 

分 类 号：R542.22[医药卫生—心血管疾病]