论文部分内容阅读
目的比较老年和年轻急性心肌梗死患者临床特点和住院期间发生心力衰竭的影响因素。方法连续入选因初发急性心肌梗死在我科住院的患者173例。根据年龄分为年轻组98例(年龄<65岁)和老年组75例(年龄≥65岁),分析两组急性心肌梗死患者一般临床特点、心血管危险因素和住院期间发生心力衰竭的影响因素。结果年轻组男性、吸烟、TG高于老年组(分别为85.7%vs42.7%,P<0.001;74.5%vs33.3%,P<0.001;2.2±0.8vs1.4±0.6,P=0005),老年组高血压病史高于年轻组(68%vs40.8%,P<0.001);年轻组CK-MB峰值、前壁心肌梗死、急诊PCI高于老年组(172±58.9vs87±13.5,P<0.001;48%vs24%,P=0.001;59.2%vs24%,P<0.001),老年组非ST段抬高心肌梗死(NSTEMI)、保守治疗、心功能级别、死亡高于年轻组(36%vs10.2%,P<0.001;58.7%vs19.4%,P<0.001;2.2±0.9vs1.7±0.8,P<0.001;14.7%vs3.1%,P=0.006);住院期间心力衰竭(Killip分级≥2)的影响因素年轻组为:年龄、性别、CK-MB、入院即刻血糖水平,而老年组则为年龄、CK-MB、入院即刻血糖水平、急诊PCI。结论老年急性心肌梗死患者常合并多种疾病,发生NSTEMI比例高,接受急诊PCI治疗者少,预后比年轻人差,而急诊PCI是老年人住院期间发生心力衰竭的一个重要影响因素。
Objective To compare the clinical characteristics of elderly and young patients with acute myocardial infarction and the influencing factors of heart failure during hospitalization. Methods A total of 173 consecutive patients admitted to our department due to initial acute myocardial infarction were enrolled. According to the age group, 98 cases (aged <65 years) in young group and 75 cases (aged ≥65 years) in elderly group were divided into two groups according to their clinical features, cardiovascular risk factors and the factors affecting HF during hospitalization . Results Young men were smokers with higher TG than the elderly group (85.7% vs 42.7%, P <0.001; 74.5% vs33.3%, P <0.001; 2.2 ± 0.8 vs 1.4 ± 0.6, P = (68% vs 40.8%, P <0.001). The CK-MB peak, anterior myocardial infarction and emergency PCI in young group were higher than those in elderly group (172 ± 58.9 vs 87 ± 13.5, P (P <0.001; 48% vs24%, P = 0.001; 59.2% vs24%, P <0.001). The NSTEMI, conservative treatment, cardiac function and death in the elderly group were higher than those in the young group (36% vs 10.2%, P <0.001; 58.7% vs 19.4%, P <0.001; 2.2 ± 0.9 vs 1.7 ± 0.8, P <0.001; 14.7% vs 3.1%, P = 0.006) Killip classification≥2) The influencing factors in young group were age, sex, CK-MB, immediate blood glucose level at admission, while the elderly group was age, CK-MB, immediate glucose level on admission, and emergency PCI. Conclusion Elderly patients with acute myocardial infarction often have multiple diseases, with a high proportion of NSTEMI, fewer patients receiving emergency PCI, and a worse prognosis than younger patients. Emergency PCI is an important factor affecting elderly patients with heart failure during hospitalization.