急性心肌梗死患者发病时间分析

Thne variation of onset of acute myocardial infarction

目的探讨急性心肌梗死（AMI）发病与时间、季节变化的关系及其临床意义。方法80例AMI患者根据昼夜发病时间分为8个时间段（23：01～2：00、2：01～5：00、5：01～8：00、8：01—11：00、11：01～14：00、14：01～17：00、17：01—20：00、20：01～23：00）。1年分6个月份段（1～2月，3～4月，5～6月，7～8月，9～10月，11～12月）。每周按天计。根据年龄分为2组〈60岁组，≥60岁组。比较各时间段和各组发病人数及百分比。统计分析采用X^2检验。结果①2组AMI昼夜发病高峰在5：01～11：00，发病率为27．9％。显著高于其他时间段（均P〈0．01）。〈60岁组发病未呈现明显高峰时段，≥60岁组发病率在8：01～11：00达到最高峰。②1周内发病情况：2组在星期二有一个显著的发病高峰。③1年内患者的发病高峰在当年11月至次年2月，显著高于其他月份（均P〈0．05）。结论AMI的发生与时间、季节密切相关。掌握AMI发病的时间规律，在心脏事件出现高峰前加强监控，可降低AMI的病死率。

Objective To explore the circadian and seasonal variation of onset of acute myocardial infarction and their clinical significance. Methods 80 patients with AMI were divided into two groups according to their age （ ≥60 years old）. The frequency of AMI onset in 8 3-hour intervals was compared and the weekly and monthly variations in these patients were evaluated. Statistical analysis was conducted by x2 test. Results The incidence of AMI showed a significant circadian,weekly and seasonal variation. More AMIs occurred from 5：01 AM to 11：00 AM as compared with other time intervals with incidence rate of 24.3% （ P 〈 0.01 ）. There were more AMIs occurring on Tuesday. The highest occurrence of AMI was found through November this year to February next year compared with other months of the year （ P 〈 0.05 ）. To those 〈 60 years old, AMI did not present peak period of onset while to those ≥60 years old,AMI occurrence peaked during 8：01-11：00. Conclusion The onset of AMI has obvious circadian,weekly and seasonal variation. This may be helpful in the prevention of the occurrence of AMI before its peak time.