初发心肌梗死前心绞痛对高龄患者预后的影响

Effect of Angina Occurred before Initial Acute Myocardial Infarction on the Prognosis of Elderly Patients

目的探讨高龄患者第一次急性心肌梗死前1周内有无心绞痛对患者近期预后的影响。方法83例年龄≥75岁的高龄老年初发急性心肌梗死患者按急性心肌梗死前1周内有无心绞痛发作分为心绞痛组(41例)和无心绞痛组(42例),观察其住院期间心律失常、心力衰竭、心源性休克发生率和病死率,并比较两组间心功能有无差异。结果心绞痛组住院期间严重心律失常、心力衰竭、心源性休克的发生率及病死率与无心绞痛组比较,差异无统计学意义(P>0.05);两组患者心功能Killip分级和超声心动图所测左室射血分数比较差异无统计学意义(P>0.05)。结论心肌梗死前心绞痛发作对高龄老年初发心肌梗死患者无保护作用,不能改善患者的近期预后。

Objective To explore the effect of angina one week before the onset of acute myocardial infarction （AMI） on the short-term prognosis of initial AMI in elderly patients. Methods Totally 83 initial AMI patients aged ≥75 years were divided into two groups： angina pectoris group （n=41） and no angina pectoris group （n=42）. Their prevalence of arrhythmia, heart failure, and cardiogenic shock, and mortality during the period of hospitalization were observed. And the heart functions of the two groups were compared. Results The rates of arrhythmia, heart failure, cardiogenic shock and mortality （P〉0.05）. Killip grading of heart function and the indices of left ventricle ejection fraction （LVEF） assessed by echocardiography showed no significant difference in the two groups （P〉0.05）. Conclusion Pre-infarction angina has less effect on short-term prognosis in elderly patients with initial AMI.