老年急性下壁心肌梗塞的临床分析

CLINICAL ANALYSIS OF AGED PATIENTS WITH ACUTE INFERIOR MYOCARDIAL INFARCTION

目的 探讨老年急性下壁心肌梗塞（ＡＩＭＩ）合并房室传导阻滞（ＡＶＢ）的临床意义及预后。方法 对１３６例老年急性心肌梗塞（ＡＭＩ）中的４５例ＡＩＭＩ进行临床分析。结果 老年 ＡＩＭＩ合并ＡＶＢ发生率显著高于前壁组（Ｐ＜０．００１），老年ＡＩＭＩ合并ＡＶＢ组肌酸磷酸激酶（ＣＰＫ）峰值（１４０７±８１０Ｕ／Ｌ）明显高于ＡＩＭＩ不合并ＡＶＢ组（８０２±２２４Ｕ／Ｌ），Ｐ＜０．０１，两组在死亡率、心源性休克、心律失常和心衰发生率方面无显著性差异。老年ＡＩＭＩ并发胸前导联ＳＴ段压低易发生左心衰竭，死亡率高。结论 老年ＡＩＭＩ伴ＡＶＢ，或入院时伴胸前导联ＳＴ段压低，应引起重视。

Objective: To investigate the clinical significance and prognosis of aged patients with acute inferior myocardial infarction. Methods Clinical analysis of 45 cases with acute inferior myocardial infarction was performed. Results The AVB incidence of AIMI was much higher than AAMI, P < 0. 001. The peak value of CPK in the group of AIMI with AVB (1407 ± 810 U/L) was higher than the group of AIMI without AVB (802 ± 224 U/L). But there was no marked differences in mortality.cardiogenicshock.arrhythmias and cardiac failure between two groups. Aged patients with AIMI accompanied by ST depression in precardial leads were easy to have left heart failure, and had a high mortality. Conclusions One must take care of the aged patients with AIMI accompanied by AVB or ST depression in precardial leads at the admission, in order to prevent the cardiac sudden death in the hospital.