老年急性心肌梗死患者心血管相关因素分析

Analysis of cardiovascular risk factors in elderly patients with acute myocardial infarction

目的分析老年急性心肌梗死患者心血管危险因素。方法选取2014年1月至2015年12月在我院住院治疗的56例年龄≥65岁的老年急性心肌梗死患者作为老年组，同时选取同一时期年龄〈65岁的非老年急性心肌梗死患者76例作为非老年组，分析老年急性心肌梗死患者出现心血管疾病的相关因素。结果老年组56例患者中合并糖尿病、高血压、血脂代谢异常者分别为29例（51．8％）、41例（73．2％）、37例（66．1％），高于76例非老年组患者12例（15．8％）、23例（30．3％）、17例（22．4％）（χ^2=9．652、8．744、11．489，P=0．002、0．003、0．001）；老年组和非老年组男性患者比例均高于女性患者；老年组16例女性患者中心血管疾病患病例数14例，占87．5%，高于非老年组32例女性患者心血管疾病患病率53．2oA（17例）（χ^2=5．510，P=0．019）；老年组患者发病后其非典型性胸痛发病率26．8%（15／56）、心力衰竭发病率64．3％（36／56）以及意识障碍的发病率23．3％（13／56），高于非老年组39．5％（3／76）、31．6％（24／76）、5．26％（4／76）（χ^2=3．965、9．075、5．365，P=0．047、0．003、0．021）。结论老年急性心肌梗死患者较易受到高脂血症、糖尿病和高血压等因素的影响，急性心肌梗死的老年患者其发病之前无显著诱因，患病时临床症状以非典型性胸痛、心力衰竭、意识障碍等为主。

Objective To analyze cardiovascular risk factors in senile patients with acute myocardial infarction（AMI）. Methods Fifty-six elderly patients with AMI aged ≥65 years were enrolled as elderly group in our hospital from January 2014 to December 2015, and 76 elderly patients with AMI aged〈65 years during the same period were selected as a non-elderly group. Cardiovascular disease-related factors were analyzed in elderly patients with AMI. Results The proportions of complicated diabetes mellitus, hypertension, and dyslipidemia were higher in 56 elderly patient[29 cases （51.8%） ,41 cases（73.2%）and 37 cases（66.1%）]than in 76 non-elderly patients[12 cases, （15.8%）, 23 cases（30.3%）and 17 cases（22.4%）, respectively,χ^2= 9. 652,8. 744,11. 489;P = 0. 002,0. 003, 0. 001]. The proportion of male elderly group and non-elderly group were higher than those of female patients. The prevalence of cardiovascular disease was 87.5 % （14/16）in female elderly patients, which was 53.2%（17/32）in female non-elderly patients（χ^2=5. 510,P=0. 019）. The incidence of a typical chest pain, heart failure and disturbance of consciousness after AMI attack was 26.8 % （15/56）, 64.3 % （36/56）and 23.3 % （13/56）in elderly group, respectively, which were higher than those in non-elderly group[39.5%（3/76）, 31.6% （24/76）, 5.26% （4/76） ; X2 = 3. 965,9. 075,5. 3651P = 0. 047,0. 003, 0.021]. Conclusions Acute myocardial infarction in elderly patients often coexists with hyperlipidemia,diabetes, high blood pressure and other risk factors. There is often no significant incentive before the onset of AMI in elderly patients. Its main clinical symptoms conclude atypical chest pain, heart failure and consciousness.