老年急性心肌梗死发病时间序列研究

An Analysis of Time Variations in the Occurrence of Acute Myocardial Infarction in the Elderly

目的分析近3年老年急性心肌梗死(AMI)发病是否具有时间变异性。方法回顾性分析我院2009—2012年心脏科老年AMI入院病例908例。分别对入院例次逐日进行统计,结合患者一般临床资料分析老年AMI发病是否具有年、季节、月、昼夜变异性及"星期几"效应。结果老年AMI发病逐年增加(P<0.01)。季节发病高峰为冬季,夏季为发病低谷。其中1月发病最高,6月发病最低。在有冠心病病史、心电图表现为ST段抬高及入院时心功能分级较差的患者中,AMI发病具有季节性差异(P<0.05)。AMI发病还具有昼夜变化规律(P<0.01),其中上午发病率最高,为(82.75±14.57)例次/月。结论研究时段内AMI发病呈逐年上升趋势,且具有季节、月、昼夜的变化规律,应据此制定相应防治措施。

Objective To determine whether a time variation could be observed in the occurance of acute myocardial infarction （AMI） in older patients during the past three years. Methods The retrospective analysis was conducted in patients diagnosed with AMI from 2009 to 2012 in the department of Cardiology of the Second Hospital of Tianjin Medical University. The daily number of hospitalized patients with AMI was calculated. Combined with the general clinical data, the occurrence of AMI in the elderly was analyzed with a seasonal or monthly or weekly variation. Results Data showed that the occurrence of AMI in older people increased year by year （P 〈 0.01）. The seasonal peak in the incidence of AMI was found in winter; while the incidence trough was in summer. The highest monthly occurrence of AMI was in January and the lowest in June. But the variation was only found in patients with coronary heart disease history, ST segment elevated in ECG or poor heart function （P 〈 0.05）. It was found that the morbidity of AMI showed circadian rhythm （P 〈 0.01）, which was the highest in the morning [ （82.75± 14.57）/month]. Conclusion Results of our study reveal that the incidence of AMI is rising year by year and shows a characteristic rhythm with respect to seasons and months, which provides the basis for formulating prevention and treatment measures.