21例老年急性心肌梗死死亡原因的临床分析

目的分析老年人急性心肌梗死（AMI）患者的住院死亡原因及相关危险因素。方法选择2010年10月～2012年10月住院的AMI患者114例，分为死亡组21例和存活组93例，对病史资料进行回顾性研究，比较两组既往病史、梗死部位、并发症等特点，分析死亡高危因素。结果老年AMI患者住院期问总病死率36．7％。多部位、广泛前壁心梗、既往有糖尿病死亡率明显高于存活组。死亡方式：泵衰竭（心衰、心源性休克或二者并存）死亡率52-3％，心脏骤停死亡率28．6％。心脏破裂死亡率4．8％，心外因素死亡率14-3％。结论老年AMI死亡率高，心力衰竭、心源性休克、心律失常是导致死亡的主要并发症。既往有糖尿病是死亡的主要危险因素。

The death causes and clinical analysis of 21 cases of aged acute myocardial infarction

Objective To analyze the death causes and related risk factors of aged acute myocardial infarction （AMI）. Methods A total of 114 aged AMI patients from October 2010 to October 2012 were divided into death group of 21 cases and survival group 93 examples. A retrospective analysis of history data between the two groups was made to compare the anamn esis, infarction site, complications and other characteristics, and analyze the death risk factors. Results The fatality rate of aged AMI patients was up to 36.7% during their hospitalization. The mortality of many parts and wide anterior wall myocardial infarction with diabetes was obviously higher than that of the survival group. Manner of death： The mortality of pump failure （heart failure, cardiac shock or both） was 52.3%,sudden cardiac arrest 28.6%, heart rupture 4.8%, and the other factors 14.3%. Conclusion The aged AMI mortality is high. Heart failure, cardiac shock, arrhythmia are the major complications which cause death. The history of diabetes is a major risk factor for death.