伴高血压的急性心肌梗塞临床特点

The Clinical Characteristics of Patients with Hypertension in Acute Myocardial Infarction

目的探讨高血压（ＨＴ）对急性心肌梗塞（ＡＭＩ）临床表现与预后的影响。方法对照分析了５３５例有ＨＴ病史和６１７例无高血压病史（ＮＨＴ）的ＡＭＩ临床资料。结果ＨＴ组吸烟、饮酒、家族史阳性者，既往有糖尿病、脑卒中、心绞痛和陈旧性心肌梗塞史者均多于ＮＨＴ组（Ｐ＜０．０５～０．００１），心绞痛的病程也较长（Ｐ＜０．００１）。ＡＭＩ于睡眠中发病，因劳累诱发者均少于ＮＨＴ组（Ｐ＜０．０５～０．００１）。ＨＴ组合并心衰、休克、室速室颤者与住院病死率均高于ＮＨＴ组（Ｐ＜０．０５～０．００１）。结论伴高血压的ＡＭＩ具有更多的冠心病危险因素，严重心脏并发症较多，近期预后较差。

Aim \ To investigate the effect of hypertension (HT)on the clinical feature and shortterm prognosis in acute myocardial infarction(AMI).\ Methods \ The clinical data of 535 AMI patients complicated with HT were analysed and compared with 617 cases of AMI with nonhypertension(NHT).\ Results \ Compared with NHT group,the HT group had higher percentages of smoking, alcoholi drinking, family history of coronary heart disease( CHD) , prior myocardial infarction, angina pectoris and diabetes mellitus (P<0.05 0.001). The duration from the first angina attack to AMI onset were longer in HT group than it in NHT group (P<0.001). In HT group AMI precipitated by physical efforts and onset during sleeping were less than those in NHT group (14.8% vs 22.5%,P<0.001 and 8.2% vs 12.0%, P<0.05). Complicated with heart failure , cardiogenic shock and ventricular tachycardia or fibrillation were all more frequent than those in NHT group(27.3% vs 18.0%, P<0.001, 15.7% vs 11.2%and 6.7% vs 3.6% P<0.05,respectively) . The inhospital mortarlity was higher in HT group than it in NHT group (17.9% vs 9.6%, P<0.001). Conclusion The AMI patients with HT were more risky with more severe complications,HT is a deteriorate factor for the prognosis of AMI.