老年人急性心肌梗死临床特点分析

Analysis of clinical characteristic of acute myocardial infarction patients of the elderly

目的探讨老年人急性心肌梗死(AMI)的临床特征。方法收集我院自2005年1月15日至2006年12月12日住院的急性心肌梗死患者临床资料,按年龄分为老年组159例(≥60岁)和非老年组121例(<60岁),分析两组在性别等各方面的差异。结果老年组男女发病率接近,非老年组男性显著多于女性,两组比较差异有统计学意义(P<0.05)。老年组中发病时有胸痛者48例(30.2%),无胸痛者111例(69.8%);非老年组中有胸痛者87例(71.9%),无胸痛者34例(28.1%),两组比较差异有统计学意义(P<0.05)。两组梗死部位基本相似(P>0.05),以广泛前壁和下壁较多。老年组有20例接受经皮冠状动脉介入治疗(PCI),非老年组有60例接受PCI。结论老年男女心肌梗死发病率相近,症状不典型,临床叙述不准确,合并症多,临床极易误诊,延误早期溶栓及急诊PTCA较多。

Objective Discussion about clinical features of acute myocardial infarction （AMI） from the elderly. Methods We collected clinical data from patients of AMI during 15th Jan in 2005 and 12th Nov in 2006. Those patients were divided into two groups as the elderly （elder than 59 years old） and not the elderly （younger than 60 years old） to compare the difference from several aspect including sex. Results There has similar incidence of AMI in the group of the elderly, but hasn＇t in the not elderly, male has visibly higher incidence than female.It has statistical significance（P〈0.05 ）.In the elderly group, 48（30.2% ） patients felt chest pain, but 111 （69.8%） patients didn＇t when AMI came on, and in the not elderly group,87（71.9%） patients felt,but 34 （28.1%） patients didn＇t.There has statistical significance between them（P〈0.05 ）.Two groups have similar（P〉0.05 ） myocardial infarction place that mostly happened in abroad frontal wall and inferior wall.20 patients in the elderly group and 60 patients in the not elderly group received percutaneous coronary intervention （PCI） treatment. Conclusion The elderly have similar Incidence of AMI between male and female, have no typical symptom, have no accurate clinical statement, and have several kinds of complication. All of them could lead misdiagnosis easily, delay early thrombosis is, and emergency PTCA.