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1983～1991年,我们共收治60岁以上的急性心肌梗塞(AMI,均按WHO的标准诊断)患者20例。现就其临床特点作如下分析讨论。 1.老年患者由于心肌萎缩,心传入神经变性。有10％～20％在AMI时缺乏典型心前区疼痛,甚至无痛。在糖尿病合并AMI患者中,则比例更高。木组无痛者占25％。但老年人对剧痛的耐受性差,易发生疼痛性休克,所以常规给予止痛药是必要的。老年AMI患者入院时1/3～1/2可有血压下降,可能继发于心律失常、迷走神经张力急剧上升(尤其是下辟梗塞,化学性机械性刺激心脏抑制性受体)。
From 1983 to 1991, we treated 20 patients with acute myocardial infarction (AMI, all diagnosed according to WHO standards) over 60 years of age. Now on the clinical features of the following analysis and discussion. 1. Elderly patients due to myocardial atrophy, cardiac afferent degeneration. 10% to 20% of the AMI lack of typical precordial pain, or even painless. In diabetes mellitus patients with AMI, the proportion is higher. Wood painless group accounted for 25%. However, the elderly are poorly tolerated by pain and are prone to have painful shock. Therefore, it is necessary to give painkillers routinely. Elderly patients with AMI admitted to hospital from 1/3 to 1/2 may have decreased blood pressure, may be secondary to arrhythmias, vagal nerve tension increased sharply (in particular, infiltration infarction, chemical mechanical stimulation of cardiac inhibitory receptors).