不同年龄急性心肌梗死患者心脏超声的临床研究

The clinical study of acute myocardial infarction using Doppler ultrasound in patients of different ages

目的评价不同年龄急性心肌梗死(AMI)患者的心脏超声及冠状动脉造影等临床特征。方法选择AMI患者325例,根据年龄分为<70岁组63例、70～79岁组140例和≥80岁组122例。对各组患者的心脏超声及冠状动脉造影等临床资料进行比较。结果与<70岁组比较,70～79岁组和≥80岁组患者心力衰竭、左心房内径≥39 mm、左心室内径≥50 mm、LVFF<50%、冠状动脉狭窄≥70%、再发心肌梗死死亡、心源性死亡的比例明显升高(P<0.05,P<0.01)。结论对年龄≥70岁AMI患者进行心脏超声检测,积极加强对危险因素干预,对预防再发心肌梗死,并减少心力衰竭、心房颤动、死亡及改善预后有重要临床意义。

Objectives To assess clinical characteristics of ultrasonogram and coronary amgiographic images of acute myocardial infarction（AMI） in patients of different ages. Methods 325 patients with AMI were divided into in 3 groups according to their ages. Group Ⅰ included 63 patients aged less than 70 years,group Ⅱ included 140 patients aged between 70-79 years and group Ⅲ included 122 patients older than 80 years. Clinical data of cardiac ultrasonography and coronary angiography were compared with each other. Results Compared with〈70 years group,the incidence of heart failure, the dimeter of left atrium≥39 ram,diameter of left ventricleS50 mm,left ventricular ejection fraction〈50% ,coronary stenosis≥70% ,rates of death from recurrent myocardial infarction and cardiogenic death and ratio of E/A≥1 were significantly higher in patients older than 70 years. The number of patients with coronary stenosis involving 2 and 3 vessels was higher than those with stenosis of single vessel. Conclusions For AMI patients older than 70 years,cardiac ultrasonography and active intervention of risk factors have important clinical significance for preventing re-infarction,decreasing heart failure, atrial fibrillation and mortality and improving prognosis.