急性心肌梗死患者临床特点的增龄分析

Age related analysis of clinical feature of patients with acute myocardial infarction

目的 :比较不同年龄段急性心肌梗死 (AMI)患者的临床特点。方法 :根据年龄将 36 4例 AMI患者分为 4组 ,40岁以下患者 5 4例 ( 组 ) ,40～ 5 9岁患者 1 5 4例 ( 组 ) ,6 0～ 79岁患者 98例 ( 组 ) ,80岁以上患者5 8例 ( 组 ) ;比较 4组患者的临床特点。结果 :AMI的发病诱因在 、 组是吸烟和饮酒 ,在 、 组为劳累、精神紧张和受凉感冒 ;诉有胸痛的患者在 、 、 和 组分别为 87.0 %、84.4%、6 1 .2 %和 41 .4% (P<0 .0 1 ) ;休克、心力衰竭、室性心律失常和房室传导阻滞患者 组和 组显著高于 组和 组 (P<0 .0 5或 P<0 .0 1 ) ;AMI1周和 4周病死率在 组患者分别为 2 1 .1 %和 2 6 .7% , 组患者为 2 7.2 %和 37.2 % ,显著高于 组(9.2 %和 1 2 .7% )及 组患者 (9.5 %和 1 6 .5 % ) ,P<0 .0 5或 P<0 .0 1。结论 :随着年龄的增加 ,AMI患者的临床特点不典型 ,伴发病、并发症和病死率逐渐增加。

Objective:To study the clinical feature of acute myocardial infarction (AMI) in different age groups.Methods:364 patients with AMI were divided into 4 groups,namely patients under 40 years old (group Ⅰ, n =54),patients aged between 40 to 59(group Ⅱ, n =154),patients aged between 60 to 79 year (group Ⅲ, n =98) and patients aged over 80 years old (group Ⅳ, n =58).The clinical features of AMI among each group were compared.Results:Main risk factors of AMI include heavy smoking and drinking in group Ⅰ and Ⅱ,exhaustion and mental stress and cold and infection in group Ⅲ and Ⅳ.87 0% and 84 4% of patients in group Ⅰ and Ⅱ complained chest pain versus 61 2% in group Ⅲ and 41 4% in group Ⅳ ( P <0 01).The signs and complications of hemodynamic impairment in group Ⅲ and Ⅳ were markedly severe than those in both groups Ⅰ and Ⅱ.In groups Ⅲ and Ⅳ,patients had a higher incidence of ventricular arrhythmias and auricularventricular block than those in groups Ⅰ and Ⅱ ( P <0 05 or P <0 01).The total one week and four week mortality rates were 21 1%,26 7% in group Ⅲ and 27 2%,37 2% in group Ⅳ versus 9 2%,12 7% in group Ⅰ and 9 5%,16 5% in group Ⅱ ( P <0 05 or P <0 01).Conclusions:The complications and mortality rate of patients with AMI increased with the increase in age.The clinical features of elderly patients were atypical.Hence,special attentions should be addressed in the treatment and prevention of AMI in these patients.