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目的探讨老年女性急性心肌梗死(acute myocardial infarction,AMI)的临床特点。方法选择AMI 240例,按年龄、性别分成老年女性组、老年男性组和非老年女性组3组,对3组的冠心病危险因素、临床表现、冠状动脉造影(CAG)检查结果、治疗措施与疾病转归进行对比分析。结果①冠心病危险因素比较:老年女性组合并糖尿病及高脂血症者所占比例高于老年男性组,差异具有统计学意义(P<0.05)。老年男性组吸烟及高血压者所占比例高于老年女性组与非老年女性组,差异均具有统计学意义(P<0.05)。②临床表现比较:老年女性组非典型心绞痛者及非ST段抬高心肌梗死者所占比例均高于老年男性组(P<0.05)。③CAG结果比较:3组梗死相关血管主要为前降支(LAD),其次为右冠状动脉(RCA)和回旋支(LCX)。老年女性组和老年男性组多支血管病变所占比例明显高于非老年女性组(P<0.05);老年女性组和非老年女性组冠状动脉狭窄程度低于老年男性组(P<0.05)。④治疗措施与疾病转归比较:老年女性组介入治疗率低于老年男性组和非老年女性组,差异均有统计学意义(P<0.05);老年女性组AMI病死率高于非老年女性组,差异有统计学意义(P<0.05)。结论老年女性AMI症状不典型,常合并糖尿病及高脂血症,冠状动脉病变以双支或多支为主,冠状动脉狭窄程度较老年男性轻,但介入治疗率低、病死率高。
Objective To investigate the clinical features of elderly myocardial infarction (AMI). Methods A total of 240 AMI patients were divided into three groups according to their age and sex. The risk factors of coronary heart disease, clinical manifestations, coronary angiography (CAG), treatment and Disease outcomes were compared. Results ① Comparison of risk factors of coronary heart disease: The proportion of elderly women with diabetes and hyperlipidemia was higher than that of the elderly men (P <0.05). The percentage of smoking and hypertension in the elderly men was higher than that in the elderly women and non-elderly women (P <0.05). ② Comparison of clinical manifestations: The proportion of elderly patients with atypical angina pectoris and non-ST segment elevation myocardial infarction was higher than that of the elderly men (P <0.05). The results of CAG: The three groups of infarct-related blood vessels were mainly anterior descending artery (LAD), followed by the right coronary artery (RCA) and the circumflex artery (LCX). The proportion of multivessel disease in the elderly female group and the elderly male group was significantly higher than that in the non-elderly female group (P <0.05). The degree of coronary artery stenosis in the elderly female group and the non-elderly female group was lower than that in the elderly male group (P <0.05). (4) Comparison of treatment measures and disease prognosis: The intervention rate of the elderly women was lower than that of the elderly men and non-elderly women (P <0.05); the mortality rate of AMI in the elderly women was higher than that of the non-elderly women , The difference was statistically significant (P <0.05). Conclusions The elderly patients with AMI usually have atypical symptoms, often complicated by diabetes and hyperlipidemia. The main coronary artery disease is double or multiple coronary artery stenosis. The severity of coronary artery stenosis is lighter than that of the elderly men, but the intervention rate is low and the case fatality rate is high.