老年急性心肌梗死的临床特点及处理

Clinical Characteristics of Acute Myocardial Infarction in Elderly Patients

目的 探讨老年急性心肌梗死 (AMI)的临床特点。方法 对我院住院的老年AMI患者的临床资料进行整理分析。结果 老年AMI患者首发症状胸痛者占 36 8% ,气促者占 2 8 9% ,腹痛、牙痛者占 2 1 4 % ,无明显症状者占 2 7% ,发病到就诊时间 1～ 17d占 2 1 1% ,只有 11 8%的患者进行溶栓治疗 ,住院病死率 17 1%。结论 老年AMI患者发病症状呈多样性 ,病死率高 ,应引起重视。

Objective To explore the clinical characteristics of acute myocardial infarction in elderly patients.Methods The elderly patients with acute myocardial infarction diagnosed from June 2000 to June 2003 in Henan Electric Hospital were retrospectively analyzed.Results The number of patients with chest pain as the first symptom was 28(36.8%) and with breathe hard as the first symptom was 22(28.9%).The time from the first symptom of AMI occurred to go to hospital was from 24h to a week.About 11.8% cases were given thrombolytic therapy,the fatality rate was 17.1%.Conclusions The study shows that many factors affect the prognosis of AMI in elderly patients and result in higher fatality rate,such as typical symptoms,go to hospital delayed,higher misdiagnosis and missed diagnosis rate,lower thrombolytic rate,more common complications as cardiogenic shock,heart failure and arrhythmia.The application of ECG and measurement of creatine kinase isoenzyme can help the diagnosis of AMI in elderly patients and the thrombolytic therapy should be considered for elderly patients.