10年间急性心肌梗死近期死亡率分析——附48例尸检病理报告

Analysis of early mortality in patients with acute myocardial infarction for ten years

本文分析我院１０ 年间住院急性心肌梗死（ＡＭＩ）患者的死亡率为１３ ％ ，约８０％ 发生在发病７ ｄ 内，头３ｄ 死亡率为４６％ 。再梗死患者死亡多在７ ｄ 内，梗死面积越大，并发症及心律失常越多，生存期越短。并发急性胃粘膜病变可提示预后不良。在ＡＭＩ的稳定期和恢复期尚不能排除猝死的可能性。尸检提示ＡＭＩ死亡的患者多为３ 支以上的血管病变。其狭窄为Ⅲ～Ⅳ级，心脏破裂发生率较高（１８ ％） ，临床诊断率４－６％ ，多发生在头７ ｄ 内。

Objective To analyse early mortality and relative factors in patients with AMIand to analyse vessels diseases by necropsy findings.Methods Atotal of 551 patients with AMI,72 died in hospital( ≤30 days) , 55 were men and 17 were women ( mean age 65-44±9-23 years) . Group I:patients died ≤7 days, Group Ⅱ:patients died > 7 days.Results The hospital mortality was 13 % for 551 patients,80 % died within 7 days,46 % died within 3 days.Compared with group Ⅱ, group Ⅰwith hypertension and heperlipidemic and dia bets mellitus were greaterthan group Ⅱ( P< 0-05) .Most ofgroup Ⅰwith first AMI,but most of group Ⅱwith rein farction( P< 0-05) .Myocardial infarctions in group Ⅰ were morethan two walls,thosein group Ⅱwere one wall ( P< 0-05) .The sudden deaths in group Ⅱwere more than thatin group Ⅰ( P< 0-01) .Necropsyfindings group Ⅰwith three vessels disease were greaterthan group Ⅱ. Conclusion Most ofdeaths with AMIoccurred with in 7 days.The greatertheinfarctions were,the morethe com plications occurred,the lees time of sarvived was.The sudden deaths in AMIoccurred possilby during the sta tionary phase and the recovery time.Necropsy prompts mostdeaths within 7 days were observed withthreevessels disease. Heart ruptures were 18 % , clinical diagnoses were 46 % .