75岁以上老年急性心肌梗死患者的临床分析

目的　了解现阶段我国老年急性心肌梗死 (AMI)患者的临床情况 ,住院期间的并发症及病死率。方法　回顾性分析我院过去 10年所有 75岁以上AMI患者住院期间的临床资料。结果　过去 10年 75岁以上急性心肌梗死老年患者占同期所有住院AMI患者的 8.9% ,其高血压、吸烟、糖尿病和高脂血症的发生率分别为 5 6 .1%、34 .4%、12 .3%和 7.9%。 6 3.1%的患者既往有心绞痛病史 ,2 4.3%有陈旧性心肌梗死病史。住院期间心力衰竭、心律失常和心源性休克的发生率分别为 38%、5 3.7%和 11.3% ,病死率为 13.3% ,明显高于同期所有AMI患者总的死亡率(5 .8% )。在透壁性AMI患者中只有 8%接受了再灌注治疗。结论　高血压和吸烟为老年AMI患者的主要危险因素 ,病死率仍居高不下 ,除与年龄因素有关外 ,还可能与这些老年患者中使用溶栓治疗较少有关。

Clinical profiles of acute myocardial infarction in aged greater than 75 years Chinese

Objective To understand the clinical profiles and complications and fatality rate during hospital stay in very elderly patients with acute myocardial infarction (AMI).Methods From Jan.1989 to Dec.1998,all AMI patients aged greater than 75 were recruited.Their clinical characteristics,risk factors,clinical presentation,treatment and complications were analyzed retrospectively.Results AMI patients(203 cases,108 men and 95 women) aged greater than 75 years accounted for 8.9% in all AMI patients(2?265 cases) in the past ten years.56.1% had hypertension, 34.4% were smokers,12.3% had diabetes mellitus.63.1% had a history of angina pectoris and 24.3% had previous myocardial infarction.As for in hospital complications,38% had heart failure,53.7% had arrhythmia and 11.3% had cardiac shock.There were 27 death (13.3%) mainly due to cardiac shock and ventricular wall rupture,which was higher than that in all AMI patients.Only 8% of AMI patients received thrombolytic therapy.Conclusions Hypertension and smoking are main risk factors in very elderly AMI patients.The fatality rate was still higher in such patients as compared with all AMI patients,probably due to less use of thrombolytic therapy.