老年急性心肌梗死低钠血症的临床意义

The clinical significance of hyponatremia in old patients with acute myocardial infarction

目的探讨老年急性心肌梗死(AMI)低钠血症的临床意义。方法选择2001年3月至2006年9月我院收治的140例老年AMI资料完整的患者进行回顾性分析,根据患者入院后即刻、24 h4、8 h血清钠离子的最低值分为三组:A组Na+≥135 mmol/L;B组Na+120-135 mmol/L;C组Na+≤120 mmol/L。比较各组心肌酶、心肌梗死面积、心力衰竭发生率及住院病死率。结果A组心力衰竭发生率为12.7%,B组为14.1%,C组为50.0%,C组与A组、B组比较具有统计学意义(P<0.05)。A组住院病死率为6.2%,B组住院病死率为7.1%,C组住院病死率为37.5%,C组与A组、B组比较均具有统计学意义(P<0.05)。C组肌酸激酶(CK)及心肌梗死面积分别与A组、B组比较有统计学意义(P<0.05)。结论老年AMI低钠血症与心肌坏死标志物、梗死面积、心力衰竭发生率、病死率密切相关,老年AMI低钠血症预后不良。

Objective To explore the clinical significance of Hyponatremia in old patients with AMI. Methods The study population consisted of 140 old patients with AMI In cardiovascular diseases room in our hospital from march 2001 to September 2006.The Patient were designed into three groups according to serum sodium concentration within twenty four to forty eight hours following the onset of AMI：Group A Na^＋≥ 135 mmol/L;Group B Na^＋ 120- 135 mmol/L;Gruop C Na^＋≤120 mmol/L.The data of myocardial enzymes,myocaxdial infarction size,heart function and inhospital mortality were analyzed retrospectively.Results The inhospital mortality of group A was 12.7% .group B was 14.1% .group C was 50.0% .The difference between group C and group B or group A was significant（ P ≤0.01 ）. Conclusion There was correlation between Hyponatreia in old patients with AMI and the date of myocardial enzymes,myocardial infarction size,heart function and inhospital motality. Hyponatremia may be the important marker that predict a worse prognosis in old patients with AMI.