CAJ | 학술논문

目的探讨年龄对老年住院急性心肌梗死(AMI)患者近期预后的影响.方法对2535例老年AMI住院患者按年龄、预后分别分组.回顾性分析年龄、并存疾病对AMI患者预后的影响.结果 80v94岁组与65～79岁组、60～64岁组比较,住院病死率升高,分别为7.5%、14.2%和22.9%(χ2=46.378,P<0.01),30 d病死率亦升高(χ2=44.534,P<0.01);60～64岁AMI患者30 d死亡组陈旧性心肌梗死、肾功能不全、肺功能不全例数高于存活组,心绞痛例数低于存活组(P<0.05);65～79岁AMI患者30 d死亡组合并陈旧性心肌梗死、高血压、糖尿病,脑血管病、肾功能不全、肺功能不全例数均高于存活组;合并心绞痛例数低于存活组(P<0.05).80～94岁AMI患者30d死亡组陈旧性心肌梗死、糖尿病、脑血管病、肾功能不全、肺功能不全例数均高于存活组,心绞痛低于存活组(P<0.05);80～94岁以上30 d死亡组与60～64岁、65～79岁的死亡组比较,陈旧性心肌梗死、高血压、糖尿病、脑血管病、肺功能不全患者增加(P<0.05).结论 AMI患者病死率随增龄而升高,不典型心绞痛是80岁及以上AMI患者死亡的独立危险因素.
목적 탐토년령대노년주원급성심기경사(AMI)환자근기예후적영향.방법 대2535례노년AMI주원환자안년령、예후분별분조.회고성분석년령、병존질병대AMI환자예후적영향.결과 80v94세조여65～79세조、60～64세조비교,주원병사솔승고,분별위7.5%、14.2%화22.9%(χ2=46.378,P<0.01),30 d병사솔역승고(χ2=44.534,P<0.01);60～64세AMI환자30 d사망조진구성심기경사、신공능불전、폐공능불전례수고우존활조,심교통례수저우존활조(P<0.05);65～79세AMI환자30 d사망조합병진구성심기경사、고혈압、당뇨병,뇌혈관병、신공능불전、폐공능불전례수균고우존활조;합병심교통례수저우존활조(P<0.05).80～94세AMI환자30d사망조진구성심기경사、당뇨병、뇌혈관병、신공능불전、폐공능불전례수균고우존활조,심교통저우존활조(P<0.05);80～94세이상30 d사망조여60～64세、65～79세적사망조비교,진구성심기경사、고혈압、당뇨병、뇌혈관병、폐공능불전환자증가(P<0.05).결론 AMI환자병사솔수증령이승고,불전형심교통시80세급이상AMI환자사망적독립위험인소.
Objective To investigate the influence of age on recent prognosis of elderly inpatients with acute myocardial infarction (AMI).Methods A total of 2535 inpatients with AMI were divided into different age groups.The influences of age and coexistent diseases on prognosis in AMI patients were analyzed retrospectively.Results The hospital mortality and 30-day mortality were higher in patients aged ≥80 years compared with patients aged 65-79 years and patients aged 60-64 years(χ2 =46.378,P<0.01 ;χ2 = 44.534, P<0.01).In 60-64 years old patients with AMI, the prevalences of old myocardial infarction (OMI), renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group (all P<0.05).In 65-79 years old patients with AMI, the prevalences of OMI, hypertension, diabetes,cerebrovascular disease, renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group(P<0.05).In 80-94 years old patients with AMI, the prevalences of OMI, diabetes, cerebrovascular disease, renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group(P<0.05).The prevalences of OMI, hypertension, diabetes, cerebrovascular disease,respiratory insufficiency were significantly increased in 80-94 years old death group versus 60-64 and 65-79 years old death group(all P<0.05).Conclusions The mortality rate of elderly patients with AMI is increased with age and atypical angina pectoris should be paid more attention in these patients.