128例老年急性心肌梗死临床诊疗特点分析

目的分析60岁以上老年人急性心肌梗死（acute myocardial infarction,AMI）的临床诊疗特点。方法采用回顾性分析方法,将年龄≥60岁的128例老年急性心肌梗死患者按性别分为男性组和女性组,按年龄分为60～69岁组、70～79岁组以及80岁及以上组,并对各组冠心病危险因素、心肌梗死的特点及治疗手段进行分析。结果老年AMI患者中,合并高血压病最多（85例,66.41%）,其次为有吸烟史（60例,46.88%）和合并糖尿病（33例,25.00%）。男性组吸烟人数显著多于女性组（P〈0.05）。女性组空腹血糖水平（fasting blood glucose,FBG）显著高于男性组（P〈0.05）。60～69岁组中有吸烟史者显著多于80岁及以上组（P〈0.05）；且60～69岁组患者的BMI显著大于80岁及以上组（P〈0.05）。ST段抬高型心肌梗死（90.63%）显著多于非ST段抬高型心肌梗死（9.37%）（P〈0.05）。2支及以上冠状动脉病变显著高于单支病变（P〈0.05）。男性组与女性组之间治疗手段无显著差异。60～69岁组中经介入治疗的患者显著多于80岁及以上组（P〈0.05）。结论高血压、吸烟及糖尿病是老年AMI最主要危险因素,应戒烟并合理控制血压、血糖水平,应提高PCI和溶栓在老年AMI患者中的治疗率,改善预后。

Clinical characteristics of acute myocardial infarction in 128 elderly patients

Objective To analyze the clinical characteristics of patients aged over 60 years old with acute myocardial infarction（ AMI）. Methods A total of 128 AMI patients ≥60 years old were divided into male group and female group by sex,and were divided into 60 ～ 69 age group,70 ～ 79 age group and ≥80 age group according to age. The clinical characteristics of the groups were analyzed and compared using retrospective analysis. Results There were 85 patients（ 66. 41%） who were merged with hypertension,60 patients（ 46. 88%） who had a history of smoking,and 33 patients（ 25. 00%） who were merged with diabetes. The number of smokers was significantly more in the male group than in the female group（ P 〈 0. 05）. The fasting blood glucose（ FBG） level was significantly higher in the female group than in the male group（ P〈 0. 05）. The smokers were more in the 60 ～ 69 age group than in the ≥80 age group（ P 〈 0. 05）. Compared with ≥80 age group,the BMI was significantly greater in the 60 ～ 69 age group（ P 〈0.05）. The patients with ST-segment elevation myocardial infarction（ 90.63%） were significantly more than non-ST-segment elevation myocardial infarction（ 9. 37%,P 〈 0. 05）. The coronary artery lesions of ≥2 vessels were significantly higher than that of single-vessel disease（ P 〈 0. 05）. The treatment means between male group and female group had no significant difference. There were more patients accepted interventional treatment in 60 ～ 69 age group than in ≥80 age group（ P 〈 0. 05）. Conclusion Hypertension,smoking and diabetes are the most important risk factors for the elderly AMI patients. Smoking cessation,the reasonable control of blood pressure and blood glucose level can contribute to the prevention of AMI. More application of PCI and thrombolytic therapy in elderly patients with AMI can improve the prognosis.