近十一年来急性心肌梗死住院患者特点的回顾

目的　了解不同时期、不同性别及年龄的急性心肌梗死 (AMI)患者的特点。方法　根据本院近 11年来收集的 30 16例AMI患者的资料 ,按不同时期、不同性别及年龄分组 ,用 χ2 检验和u检验进行多侧面分析比较。结果　(1)近 11年来收治的AMI病例数大体呈逐年升高的趋势 ,AMI患者的总体住院天数及住院病死率有显著下降 ,但老年AMI患者人数构成比增加 ,特别患AMI再住院的老年患者人数构成比显著增加 ,同时住院费用也急剧增加。 (2 )性别比较发现 ,90年代后期患AMI第一次住院的青年男性患者及老年女性患者有明显增多趋势。 (3)住院病死率分析发现 ,90年代后期AMI住院病死率的下降主要体现在老年男性患者住院病死率的下降 ,而中青年男性患者及女性住院病死率无明显下降。 (4)死因分析 ,男女总死因的前三位均为心力衰竭 ,心源性休克以及心力衰竭并休克。男性≤ 6 0岁组心源性休克明显占较高比例。 (5 )比较男女部分特点发现 ,未经年龄校正前女性的住院病死率明显高于男性 ,经年龄校正后差异变得不显著。女性比男性更少接受冠脉造影和 或PTCA术 ,再住院率较高。结论　AMI患者近 11年来呈逐年升高的趋势 ,住院病死率明显下降 ,男性发病年轻化

Retrospective analysis of characteristics of the inpafients with acute myocardial infarction during the latest 11 years

Objective To find out the characteristics of the patients with acute myocardial infarction(AMI) who were admitted to our hospital during 11 years(1990～2000).Methods Data of consecutive 3?016 patients with AMI were collected and analysed by χ 2 test and u test.Results (1)During the latest 11 years,the number of inpatients with AMI had the tendency of increase year after year, while the hospitalization days and mortality rate decreased significantly.(2)The constituent ratio of the old inpatients with AMI increased significantly,especially the rehospitalized old patients.Meanwhile, the hospitalization cost increased very significantly,too.The young male patients and the old female patients hospitalized for first attack of AMI showed a very significant tendency of increase.(3)The mortality of the patients with AMI decreased mainly in the old patients during the late 1990s,but that of the middle aged and young male patients and female patients did not decrease significantly.(4)The first three causes of death were heart failure,cardiogenic shock and heart failure complicated by shock.High proportion of patients ≤60 yrs died of cardiogenic shock.(5)The unadjusted hospitalization mortality rate of the females was significantly higher than that of the males,but the mortality had no statistically significant difference after adjusted for age. Female patients received coronary arteriography and/or PTCA less frequently and had higher rehospitalization rate than the males.Conclusion There are tendencies that AMI patients admitted to our hospital have increased gradually during the latest 11 years(1990～2000).The mortality of inpatients decreased significantly and male cases became younger.