高龄患者急性心肌梗死发作的时间节律与梗塞部位的分析

目的探讨急性心肌梗死(AM I)发作的时间节律的规律性。方法对997例(其中包括412例前壁和423例下壁的AM I患者)的梗塞发生时间、梗塞部位进行分析。结果高龄患者急性心肌梗死的发生率在06∶00到12∶00最高(n=257,占30.78%),而00∶00到06∶00,发生下壁心肌梗死的危险性明显高于其它时间点(n=138/423,32.62%,P<0.01),从06∶00到12∶00,发生前壁心肌梗死的危险性却明显高于其它时间点,(n=156/412,37.86%,P<0.01)。结论急性心肌梗死的发病具有明显的时间节律性,护士应掌握急性心肌梗死发作的时间节律,有针对性的进行监护,提高抢救成功率。

Study of circadian distribution in old patients with acute myocardial infarction

Objective Acute myocardial infarction follows a circadian pattern with a morning peak ascribed to sympathetic activation. These events may have different characteristic, we want to find some clincal characteristics. Methods we studied 997 old patients with acute myocardial infarction （412 anterior and 423 inferior acute myocardial infarction） . The time of the infarction ,its anatomic location and change of ST segment were analysed. Results Inferior myocardial infarction were more frequent during the night （ midnight to 6AM than other periods of the day, n = 138,32.62% of all inferior myocardial infarctions,P 〈0.01 ）. Anterior myocardial infarction were more frequent during the day （6Am to noon than during other periods of the day, n = 156,37.86% of all anterior myocardial infarctions. P 〈 0. 01 ）. Conclusion In order to monitoring signs of acute myocardial infarction early and increase rescue ratio, Nurse should handle circadian distribution in old patients with acute myocardial infarction.