急性心肌梗死426例临床特征分析

Analysis of clinical features of 426 patients with acute myocardial infarction

目的 探讨急性心肌梗死（AMI）患者的临床特征、药物治疗、并发症及病死率的差异.方法 回顾性分析426例AMI患者的一般情况、病史特征、诊断、治疗、并发症和预后等.比较老年（≥70岁）和非老年（＜70岁）患者、男性和女性患者的临床特征、治疗、并发症及病死率的差异.结果 老年AMI患者吸烟率明显较低（P＜0.05）,女性患者、有陈旧心肌梗死病史者、心功能≥Killip Ⅲ级者患病率明显增高（均P＜0.05）.老年和非老年患者在利尿剂、β受体阻滞剂、洋地黄类、氯吡格雷等药物的应用上差异均均有统计学意义（P＜0.05）.老年患者完全性左束支传导阻滞、房室传导阻滞、心房颤动的发生率均高于非老年患者（均P＜0.05）,而病死率差异无统计学意义（P＞0.05）.女性患者发病年龄明显大于男性患者（P＜0.05）,且吸烟率低,有明确心绞痛病史者比率高,心肌梗死后心功能差（均P＜0.05）.除了营养心肌药物应用女性患者高于男性外,其他常规治疗药物应用比率、并发症及预后差异均无统计学意义（均P＞0.05）.结论 AMI是危及人类生命的重要疾病,不同年龄患者有其各自临床特征,且不受性别影响.

Objective To analyze clinical characteristics, hospital treatment, complications and mortality differences of the patients with acute myocardial infarction （AMI） by conventional treatment. Methods Retrospective analysis of 426 cases of AMI patients, aged 20-103 years [mean age（67. 82 ±0. 56） years] ,male 261 cases,female 165 cases, the general condition of patients were recorded, history features, diagnosis, treatment, complications and prognosis. Comparison of elderly（≥70 years） and non-elderly（〈70 years） ,male and female patients with clinical features, treatment, complications and mortality differences. Results Compared with the non-elderly patients with AMI,elderly patients had significantly lower smoking history（P〈0.05） ,female ratio,history of old myocardial infarction rate, cardiac function≥Killip Ⅲ level was significantly higher（all P〈0.05）. During hospitalization in patients of different ages diuretics,β blockers, digitalis, clopidogrel and other drugs, application of a significant difference （all P〈0.05）. Elderly AMI patients with complete left bundle branch block,atrioventricular block,atrial fibrillation,the incidence was higher than non-elderly patients （all P〈0.05） ,but no difference in mortality between the two groups （P〉0.05）. Female patients than male patients with age of onset was significantly （P〈0.05） , and the smoking rate is low,but clearly the high rate of angina died（P〈0.05） ,sub-poor cardiac function after myocardial infarction（P〈0.05）. Application of cardiac drugs in addition to nutrition than men,female patients, the rate of other conventional therapy,no difference in both complications and prognosis（all P〉0.05）. Conclusion AMI was the major diseases threatening human life,different age had its own clinical characteristics of patients,and it could not be impacted by gender.