老年人急性心肌梗塞的首发症状特点

• 作 者: 董立钧 张培菊 吴宁 黄小芹
• 机 构: 济宁医学院附属医院,济宁老年血管病医院
• 出 处: 济宁医学院学报
• 发表日期: 1998年01期
• 关键词: 急性心肌梗塞 急性左心衰竭 呼吸困难 梗塞部位 心排量 陈旧性心肌梗塞 心功能不全 一过性脑缺血 迷走神经张力 脑梗

目的为探讨老年人心肌梗塞的首发症状。方法回顾性分析了１３５例急性心肌梗塞患者，老年组（＞６０岁）９０例，成年组（＜６０岁）４５例。结果老年人急性心肌梗塞首发症状的特点为：消化道症状最常见，老年组３２２％，成年组８９％，Ｐ＜００１；出现胸痛症状的显著低于成年组，老年组３７７％，成年组８４４％，Ｐ＜００５；以急性左心衰竭表现为首发症状的老年组显著高于成年组（Ｐ＜００５）；神经精神症状较成年组多见。结论对老年人突然出现恶心、呕吐、腹痛、呼吸困难、头晕、晕厥、偏瘫、失语等症状者，应行常规心电图检查，防止老年急性心肌梗塞的误诊。

Objective To investigate the first symptom of myocardial infarction in the elderly. Methods Retrospective analysis of 135 patients with acute myocardial infarction, 90 cases of elderly (> 60 years old), 45 cases of adult (<60 years old). Results The characteristics of the first symptom of acute myocardial infarction in the elderly were as follows: the most common gastrointestinal symptoms were 32.2% in the elderly group and 89% in the adult group (P <001). The symptoms of chest pain were significantly lower than those in the adult group and the elderly group 377% in adult group and 844% in adult group (P <005). The incidence of acute left heart failure in the elderly group was significantly higher than that in the adult group (P <005). The neuropsychiatric symptoms were more in the adult group see. Conclusion Acute electrocardiographic examination should be performed on elderly patients with sudden nausea, vomiting, abdominal pain, dyspnea, dizziness, fainting, hemiparesis and aphasia to prevent the misdiagnosis of elderly patients with acute myocardial infarction.