老年急性心肌梗死的临床特征

Clinical characteristics of acute myocardial infarction in the aged

目的 了解老年急性心肌梗死 (AMI)患者的临床特征及预后。方法 我院冠心病监护病房 (CCU)收治的 5 2 2例AMI患者 ,根据患者发病年龄分为老年组 2 5 8例 ,对照组 2 6 4例。结果 ( 1)老年组女性占的比例大 ( 37.98%比 2 3 .48% ,P <0 .0 1) ;老年组伴糖尿病 (DM ) ( 2 9.45 %比 4.5 5 % ,P <0 .0 1)、陈旧性心肌梗死 (OMI) ( 13 .18%比 7.2 0 %P <0 .0 5 )、脑卒中 ( 11.2 4%比 4.5 5 % ,P <0 .0 1)多。( 3)老年组AMI发病前有明显诱因者所占的比例少 ( 16 .2 8%比 2 5 .76 % ,P <0 .0 1)、无痛性心肌梗死所占比例大 ( 2 0 .5 4%比 8.33 % ,P <0 .0 1)、就诊时间 (h)晚 ( 9.2 5± 2 .6 3比 5 .74± 1.36 ,P <0 .0 1)、接受静脉溶栓治疗的少 ( 34.5 0 %比 5 0 .38% ,P <0 .0 1)、住院病死率高 ( 14 .73 %比 3 .41% ,P <0 .0 1)。

Objective To investigate the clinical characteristics and prognosis of acute myocardial infarction (AMI) in senile patients.Methods 552 patients with AMI in coronary care unit (CCU) of our hospital were divided into two groups according to thire age,258 cases were in senile group and 264 cases were in control group.Results (1)Most of the patients in senile group were female (37.89% vs 23.48%,P<0.01);(2)In senile group the incidence of complications was significantly higher than those in control group,such as diabetes mellitus (29.45% vs 15.15%,P<0.01),remote myocardial infarction (13.18% vs 7.20%,P<0.05),stroke (11.24% vs 4.55%,P<0.01).(3)In senile group the patients who had obvious inducement were less than those in control group (16.28% vs 25.76%,P<0.01);the patients without chest pain were more (20.54% vs 8.33%,P<0.01);the ones late for hospitalizing were more (9.25% vs 5.74%,P<0.01);the ones receiving thrombolysis therapy were less (34.50 50.38,P<0.01);mortality rate was higher (14.73 vs 3.41,P<0.01).Conclusion The study suggests that the senile patients with AMI have worse clinical outcome.