中老年急性心肌梗死临床特点对比分析  

Clinical Features of Acute Myocardial Infarction:Comparison between Middle-aged and Elderly Patients

作　　者：阿力木江.阿不来提 赵璇[1] 陈洋[1] 热娜古丽[1] 宋泽军[1] 徐海蓉[1] 

机构地区：[1]武警新疆总队医院心内科,新疆乌鲁木齐市830099

出　　处：《中国全科医学》2014年第8期934-937,共4页Chinese General Practice

摘　　要：目的对比中老年急性心肌梗死(AMI)患者的临床特征、心电图改变、并发症发生情况及治疗情况等,为老年AMI的诊治提供参考。方法选择2010年12月—2013年7月我院心脏病监护病房(CCU)收治的中老年AMI患者119例,其中老年人62例列入老年组,平均年龄为(72.8±5.6)岁;中年人57例列入中年组,平均年龄为(52.4±7.0)岁。比较两组患者临床特征、心电图改变、并发症发生情况及治疗情况等。结果老年组患者典型胸痛发生率、吸烟率、冠心病家族史阳性率均低于中年组(P<0.05),不典型胸痛、呼吸困难、心悸发生率均高于中年组(P<0.05),入院时心功能Killip's分级Ⅰ级比例小于中年组(P<0.05),入院时心功能Killip's分级Ⅲ级比例及无危险因素比例均大于中年组(P<0.05)。两组患者心电图改变比较,差异无统计学意义(P>0.05)。老年组患者心功能不全、心律失常、出血发生率均高于中年组(P<0.05)。老年组患者接受β受体阻滞剂、急诊冠状动脉介入(PCI)治疗率均低于中年组,平均进门-球囊扩张时间长于中年组(P<0.05)。结论中老年AMI临床特点存在诸多不同,老年患者症状不典型,易导致误诊或漏诊,且急诊PCI治疗率较低,应加以重视。Objective To compare the clinical features,ECG changes,complications and treatments of acute myocardial infarction（AMI）between middle-aged and elderly patients,to provide base for the diagnoses and treatments of AMI in elderly patients.Methods A total of 119 AMI patients admitted to this hospital from December 2010 to July 2013 were divided into groups elderly[n=62,averagely aged（72.8±5.6）years],middle-aged[n=57,averagely aged（52.4±7.0）years].The clinical features,ECG changes,complications and treatments were compared between 2 groups.Results Typical chest pain incidence,smoking rates,positive rate of family history of coronary heart disease（CHD）were lower in elderly group than in middle-aged group（P＜0.05）,the incidences of atypical chest pain,dyspnea,cardiopalmus higher（P＜0.05）,the proportion of grade Ⅰ of heart function Killip′s grading on admission smaller（P＜0.05）,the proportion of grade Ⅲ and that of non-risk factors greater（P＜0.05）.No significant difference was noted in ECG changes between 2 groups（P＞0.05）.The rates of receiving treatments of β receptor-blocker,emergency percutaneous coronary intervention（PCI）were lower in elderly group than in middle-aged group,the mean door-to-balloon time longer（P＜0.05）.Conclusion There are a lot of differences in clinical features of AMI between middle-aged and elderly patients.Elderly patients have more atypical symptoms,which is easy to lead to misdiagnoses or missed diagnoses,and their emergency PCI treatment rate is low.

关 键 词：心肌梗死 中年人 老年人 疾病特征 对比研究 

分 类 号：R542.22[医药卫生—心血管疾病]