急性心肌梗死患者院外发病特点及现场病死率相关因素：366例分析

Analysis of the characteristics of acute myocardial infarction and the correlative factors of pre-hospital mortality:analysis of 366 cases

目的分析不同部位急性心肌梗死的院外发病特点,心搏骤停(cardiac arrest,CA)发生率,及院外现场病死率的相关因素。方法将366例患者的心肌梗死部位按构成比排序,分析不同梗死部位的男女构成比,梗死部位与发生CA及现场病死率的关系。比较男女发病年龄。结果急性下壁心肌梗死占总发病的29.78%,前壁占20.23%,广泛前壁占15.30%。急性广泛前壁心肌梗死CA发生率为19.64%。各部位急性心肌梗死患者中均为男性多于女性(均P<0.05)。70～79岁年龄段急性心肌梗死发病人数最多。女性平均发病年龄晚于男性约10年。70～79岁对男女而言均为高发年龄段。梗死面积与CA发生率呈正相关(P<0.05)。CA发生率为9.84%,现场死亡率为6.83%。结论院外急性心肌梗死以下壁最多见,多合并缓慢型心律失常。急性广泛前壁心肌梗死CA发生率最高。各部位急性心肌梗死患者中均为男性多于女性。心肌梗死多见于70～79岁。

Objective To analyze the characteristics of acute myocardial infarction(AMI)in different suffering loca- tions and the correlative factors of pre-hospital mortality.Methods The clinical data of 366 patients of AMI who underwent on-the-spot rescue were analyzed.Results Infarction of the inferior wall accounted for 29.78%,infarction of the anterior wall accounted for 20.23%,and extensive infarction of anterior wall accounted for 15.30%.Among all the groups,the inci- dence rates of AMI in different suffering locations were all significantly higher in the males than in the females(all P<0.05). Most patients were aged 70～79 for both sexes.The average onset year of females was 10 years later then that of males.The inci- dence of CA was 9.84%.The morbidity of CA was positively correlated with infarction area(P<0.05).The pre-hospital mortality of AMI was 6.83%.Conclusion Most pre-hospital AMI occurred in the interior wall the complicated form of CA of which was chronic.Acute extensive MI of anterior wall has the highest morbidity rate of CA.The incidence rates of AMI in differ- ent locations are all higher in the males than in the females.Most of the AMI cases occurs in the persons aged 70～79.