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目的探讨高龄急性心肌梗死(AMI)的临床特点及危险因素.方法对住院AMI患者的临床资料进行统计,回顾性分析年龄≥75岁的高龄AMI患者的临床特点及危险因素.结果①高龄组AMI女性发病率明显高于男性;②高龄组症状不典型AMI占75%,明显高于对照组,组间比较差异有统计学意义(P<0.01);③高龄组无Q波型AMI占43.5%,多部位AMI占54.6%,均明显高于对照组,差异有统计学意义(P<0.05);④高龄组合并有高血压病,高脂血症,糖尿病分别为63.9%,58.3%,41.7%,与对照组相比,有明显的统计学差异(P<0.01);⑤高龄组心律失常、心力衰竭、心源性休克、急性脑血管意外发病率分别为75.9%、48%、17.6%、26.8%,与对照组相比,有明显的统计学差异(P<0.05),且病死率明显高于对照组。结论高龄AMI患者女性发病率明显高于男性,较中青年AMI更多表现为无Q波型心肌梗死和多部位心肌梗死,易并发心律失常、心力衰竭、心源性休克、急性脑血管意外、感染等,病死率高;高血压、高脂血症、糖尿病是高龄AMI的最重要危险因素。
Objective To investigate the clinical features and risk factors of elderly acute myocardial infarction (AMI) .Methods The clinical data of AMI patients were analyzed retrospectively, and the clinical features and risk factors of AMI patients older than 75 years old were retrospectively analyzed.Results ① The AMI The morbidity of female was significantly higher than that of male. ② The atypical AMI in advanced age group was 75%, which was significantly higher than that in control group (P <0.01). ③ The Q-wave AMI accounted for 43.5% , AMI accounted for 54.6% in multiple sites, which were significantly higher than those in control group (P <0.05) .④Hypertension, hyperlipidemia and diabetes mellitus were 63.9%, 58.3% and 41.7 (P <0.01) .⑤The incidence of arrhythmia, heart failure, cardiogenic shock and acute cerebrovascular accident were 75.9%, 48% and 17.6% respectively in the advanced age group (P <0.01) , 26.8% respectively. Compared with the control group, there was a significant difference (P <0.05) and the mortality was significantly higher than that of the control group. Conclusion The incidence of AMI in elderly patients was significantly higher than that of males. Compared with young AMI, AMI showed more Q-wave myocardial infarction and multiple myocardial infarction, complicated with arrhythmia, heart failure, cardiogenic shock, acute cerebrovascular accident, Infection, high mortality; hypertension, hyperlipidemia, diabetes mellitus is the most important risk factor for elderly AMI.