不同年龄老年急性心肌梗死住院患者近期预后的临床分析

目的 探讨年龄对老年住院急性心肌梗死(AMI)患者近期预后的影响.方法 对2535例老年AMI住院患者按年龄、预后分别分组.回顾性分析年龄、并存疾病对AMI患者预后的影响.结果 80v94岁组与65～79岁组、60～64岁组比较,住院病死率升高,分别为7.5%、14.2%和22.9%(χ2=46.378,P<0.01),30 d病死率亦升高(χ2=44.534,P<0.01);60～64岁AMI患者30 d死亡组陈旧性心肌梗死、肾功能不全、肺功能不全例数高于存活组,心绞痛例数低于存活组(P<0.05);65～79岁AMI患者30 d死亡组合并陈旧性心肌梗死、高血压、糖尿病,脑血管病、肾功能不全、肺功能不全例数均高于存活组;合并心绞痛例数低于存活组(P<0.05).80～94岁AMI患者30d死亡组陈旧性心肌梗死、糖尿病、脑血管病、肾功能不全、肺功能不全例数均高于存活组,心绞痛低于存活组(P<0.05);80～94岁以上30 d死亡组与60～64岁、65～79岁的死亡组比较,陈旧性心肌梗死、高血压、糖尿病、脑血管病、肺功能不全患者增加(P<0.05).结论 AMI患者病死率随增龄而升高,不典型心绞痛是80岁及以上AMI患者死亡的独立危险因素.

Clinical analysis of recent prognosis of elderly inpatients at different ages with acute myocardial infarction

Objective To investigate the influence of age on recent prognosis of elderly inpatients with acute myocardial infarction (AMI).Methods A total of 2535 inpatients with AMI were divided into different age groups.The influences of age and coexistent diseases on prognosis in AMI patients were analyzed retrospectively.Results The hospital mortality and 30-day mortality were higher in patients aged ≥80 years compared with patients aged 65-79 years and patients aged 60-64 years(χ2 =46.378,P<0.01 ;χ2 = 44.534, P<0.01).In 60-64 years old patients with AMI, the prevalences of old myocardial infarction (OMI), renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group (all P<0.05).In 65-79 years old patients with AMI, the prevalences of OMI, hypertension, diabetes,cerebrovascular disease, renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group(P<0.05).In 80-94 years old patients with AMI, the prevalences of OMI, diabetes, cerebrovascular disease, renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group(P<0.05).The prevalences of OMI, hypertension, diabetes, cerebrovascular disease,respiratory insufficiency were significantly increased in 80-94 years old death group versus 60-64 and 65-79 years old death group(all P<0.05).Conclusions The mortality rate of elderly patients with AMI is increased with age and atypical angina pectoris should be paid more attention in these patients.