80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80岁以上老年急性心肌梗死(AMI)患者的临床情况，住院期间的并发症及死亡率。方法 回顾性分析解放军总医院过去十年间80岁以上121例次AMI患者住院期间的临床资料。结果 以呼吸困难为首发症状的占56．9％。高血压、糖尿病、吸烟的发生率分别为57％，33．1％，24％。住院期间最多见的并发症为心律失常，占43％，其次是肺炎(25．6％)、充血性心力衰竭(23．1％)。其中只有6．6％接受了再灌注治疗。住院期间死亡率24．8％。结论 本组老年AMI发病症状不典型，高血压和糖尿病为本组老年AMI患者的主要危险因素，死亡率较高，除与年龄因素有关外，还可能与这些老年患者使用溶栓治疗较少有关。

Clinical profiles of acute myocardial infarction in aged older than 80 years Chinese

Objective To understand the clinical profiles and complication and mortality during hospital stay in very elderly patients with acute myocardial infarction (AMI). Methods From Dec.1991 to Jan. 2002, about 121AMI patients aged older than 80 were recruited in The total hospital of liberation army. Their clinical characteristics,risk factors, clinical presentation,treatment and complications were analyzed retroepectively. Results Dyspnea as the first symptom had 56.2%. The hypertension, diabetes, and smoking was 57%, 33.1%, 24% respectively. As for in hospital complication, 43% had arrhythmia, 25.6% had pneumonia and 23.1% had congestive heart failure. Only 6.6% of AMI patients received thrombolytic therapy. The mortality was24.8%. Conclusion The clinical presentation of AMI can be quite atypical. Hypertension and diabetes are main risk factor in very elderly AMI patient, The mortality was high probably due to less use of thrombolytic therapy besides age factor.