老年人急性心肌梗死的临床特点

Clinical Characteristics of The Elderly Acute Myocardial Infarction

目的探讨老年人急性心肌梗死旳临床特点。方法回顾我院2010年11月至2011年12月收治的108例心肌梗死患者临床资料,对比分析老年组(61例,≥65岁)与非老年组(47例,<65岁)无胸痛时的主要临床症状、梗死部位、主要合并症和并发症以及治疗和预后等方面情况差异。结果老年组无胸痛者39例,占本组63.9%,非老年组无胸痛者9例,占本组19.1%;两组患者经心电图检查后发现,其梗死发生的部位情况接近,组间比较差异无显著性(P>0.05);老年组在心律失常、心力衰竭以及急性脑血管意外等情况的发生率显著高于非老年组(P<0.05);老年组死亡15例,占本组24.6%,非老年组死亡7例,占本组14.9%。组间病死率比较具显著性(P<0.05)。结论 AMI与性别及年龄具有一定相关性,老年人AMI临床多数表现为无痛或非典型性胸痛,且具有更多的并发症和更高的病死概率,熟悉老年心肌梗死的临床特点,尽早诊断并采取积极有效的预防和治疗措施,对降低老年急性心肌梗死具有十分重要的临床意义。

Objective To investigate the clinical characteristics of the acute myocardial infarction.Methods Our review in November 2010 to December 2011,108 patients with myocardial infarction were patient＇s clinical material,comparative analysis the elderly group（n= 61,≥65 years old） and the elderly group（47 cases,65 years old） no chest pain the main clinical symptoms,infarct,main complication and complications,and treatment and prognosis of difference situation.To investigate the clinical characteristics of the acute myocardial infarction.Results Old no chest pain is 39 cases,accounting for 63.9% of the group,the incidence is no chest pain in 9 cases,accounting for 19.1% of the group;Two groups of patients by electrocardiogram inspection found that the infarction happened site situation close,there was no significant difference between group is sex（P0.05）;Old in the arrhythmia,heart failure,and acute cerebrovascular accident incidence of the circumstance such as significantly higher than the elderly group（P0.05）;Old healed death 15 cases,accounting for 24.6% of the group,the old death 7 cases,accounting for 14.9% of the group.Comparison between groups with mortality（P0.05）.Conclusion AMI and gender and age has a certain correlation,the elderly AMI clinical most performance for painless will atypical chest pain,and more complications and higher chance to illness,familiar with the old myocardial infarction the clinical features,early diagnosis and take the positive and effective prevention and treatment measures,and to reduce the elderly acute myocardial infarction has very important clinical significance.