老年继发性心肌梗死的诊断治疗

Diagnosis and treatment of secondary myocardial infarction in the elderly

根据第4版心肌梗死(简称心梗)全球统一定义,按病理生理机制将心梗分为Ⅰ至Ⅴ型,其中Ⅱ型心梗又称继发性心梗,是由于心肌的血氧供需失衡导致的心肌梗死。老年患者为其高发人群,且老年患者通常预后更差。由于针对老年继发性心梗的临床研究较少,对其诊断、治疗的循证依据尚存在空白,临床医师对本病及其危害的认识严重不足,文章结合现有文献和团队经验对老年继发性心梗的诊断及治疗要点做一论述。

The Fourth Universal Definition of Myocardial Infarction classifies myocardial infarction into five different subtypes based on pathophysiological mechanisms,of which,type II myocardial infarction(T2MI)is also known as secondary myocardial infarction,which results from the imbalance of the oxygen supply and demand of the myocardium.Elderly people are the high-incidence population for this disease and always suffer from even poorer prognosis.Due to the small number of studies on T2MI in elderly subjects and insufficient evidence-based recommendations for diagnosis and treatment,the disease and its harm have not attracted enough attention from clinicians.This paper will discuss the diagnosis and treatment of T2MI in the elderly based on the existing literature and our experience.