老老年急性心肌梗死临床特征分析

目的探讨老老年急性心肌梗死(AMI)的临床特点和危险因素。方法将56例确诊AMI的老老年患者(≥80岁)与同期62例确诊AMI的中青年患者(≤60岁)进行对照研究,分析其危险因素、性别差异、起病诱因、发病的临床表现、梗死部位、并发症和死亡率。结果老老年组高血压、糖尿病和高脂血症明显高于中青年组,差异有统计学意义(P<0.01);而冠心病家族史、吸烟两项危险因素明显低于中青年组,差异有统计学意义(P<0.01)。老老年组症状多不典型,以多支病变为主,并发症较多;中青年组患者发病前大多有明确诱因,多有典型的胸骨后或心前区疼痛,以单支病变为主,并发症相对较少。结论老老年急性心肌梗死临床特点和危险因素不同,需注意高血压,糖尿病和高脂血症等危险因素的合理治疗及监测。

Clinical Characteristic Analysis of Acute Myocardial lnfarefion of Elderly Patients.

Objective Investigate the chnical characteristics and risk factors of very elderly patients （ 〉 80 years） with acute myocar- dial infarction （AMI）. Methods The study included of 56 cases of very elderly patients diagnosed with AMI and 62 cases of young patients （ 〈 60 years old） confirmed AMI at the same period, to analyze the risk factors, and gender differences in the onset of incen- fives, the onset of clinical manifestations, infarction, comphcationsand mortality. Results Hypertension, diabetes and hyperlipidemia in the elderly patients group was significantly higher than that of the young ones group （ P 〈 0.01 ） ; family history of coronary artery disease, smoking was significantly lower than the young group （ P 〈 0.01）. Elderly group with atypical symptoms, multivessel dis- ease, more comphcafions. The young patient groups were mainly single vessel disease. The prognosis is good, and had relatively few complications. Conclusions The clinical features and risk factors of elderly patients with acute myocardial infarction were different. The very elderly patients should pay more attention to reasonable treatment and monitoring of risk factors such as hypertension, dia- betes and hyperlipidemia.