年龄对急性心肌梗死患者住院期预后的影响
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- 论文作者：张宗艳
- 年：2016
- 作者机构：天津市滨海新区大港医院急诊科;
- 论文关键词：心肌梗死 ; 年龄 ; 病死率 ; 老年
- 英文论文关键词：myocardial infarction ; age ; mortality ; older patiets
- 会议召开时间：2016-11-25
- 会议录名称：湖南中医药大学学报2016/专集：国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会论文集
- 语种：中文
- 分类号：R542.22
- 学会代码：HNZY
- 会议名称：国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会
- 会议地点：中国广东珠海
- 主办单位：国际数字医学会、Digital Chinese Medicine
- 学会名称：湖南中医药大学期刊杂志社
- 页数：2
- 文件大小：1918k
- 原文格式：D
- 会议级别：全国
摘要
目的探讨年龄对急性心肌梗死(acute myocardial infarction AMI)患者住院期预后的影响。方法对1080例AMI患者按年龄分组,回顾分析年龄对AMI患者预后的影响及不同年龄组合并症、并发症检出率差异。结果随着增龄住院病死率增加,<60岁组1.9%(6/314),60~69岁组4.6%(12/262),70~79岁组14.4%(48/333),≥80岁组16.4%(28/171);<70岁两组间病死率与≥70岁两组间病死率差异均无统计学差异(P<0.05),<70岁两组分别与≥70岁两组比较病死率有统计学差异(P<0.05);≥70岁组高血压病、糖尿病、脑梗死、充血性心力衰竭及肺炎检出率较<70岁组高,差异有统计学意义(P<0.05)。结论老年AMI患者,尤其是70岁以上AMI患者,心血管合并症多,病情复杂,并发症发生率高,住院期病死率高。
Objective To explore the influence of age on the in-hospital outcome of patients with acute myocardial infarction(AMI).Methods A total of 1080 consecutive patientswith AMI were enrolled in the study. The influences of age on prognosis in AMI patients were analyzed retrospectively. Combination and ?complications of AMI patient in different age stagewere further analyzed. Results Mortality in different age groups(<60 years,60-69 years,70-79 years and ≥ 80 years)were 1.9 %(6/314),4.6 %(12/262),14.4 %(48/333)and 16.4%(28/171),respectively.The mortality increased with age. There was no statistical difference both the two groups < 70 years(P > 0.05) and the two groups ≥ 70 years(P > 0.05); Therewas significant statistical difference between each group of < 70 years and ≥ 70 years(P < 0.05). Detection rates of hypertension, diabetes, cerebral infarction, heart failure and pneumonia in ≥ 70 years AMI patients were higher than that in < 70 years. Conclusions The elderly patients with AMI had more cardiovascular complications. The mortality was higher in the older patients, especially in the elderly over the age of 70.
Objective To explore the influence of age on the in-hospital outcome of patients with acute myocardial infarction(AMI).Methods A total of 1080 consecutive patientswith AMI were enrolled in the study. The influences of age on prognosis in AMI patients were analyzed retrospectively. Combination and ?complications of AMI patient in different age stagewere further analyzed. Results Mortality in different age groups(<60 years,60-69 years,70-79 years and ≥ 80 years)were 1.9 %(6/314),4.6 %(12/262),14.4 %(48/333)and 16.4%(28/171),respectively.The mortality increased with age. There was no statistical difference both the two groups < 70 years(P > 0.05) and the two groups ≥ 70 years(P > 0.05); Therewas significant statistical difference between each group of < 70 years and ≥ 70 years(P < 0.05). Detection rates of hypertension, diabetes, cerebral infarction, heart failure and pneumonia in ≥ 70 years AMI patients were higher than that in < 70 years. Conclusions The elderly patients with AMI had more cardiovascular complications. The mortality was higher in the older patients, especially in the elderly over the age of 70.
引文
[1]马涵英,周玉杰,Dick RJ,等.85岁以上老年冠心病患者经皮冠状动脉支架治疗的临床观察.中华老年医学杂志,2008,7;502-505.
[2]金泽宁,陈韵岱,潘伟琦,等.不同治疗方式对老年急性ST段抬高心肌梗死的临床疗效分析.中国实用内科杂志,2008,5:399-351.
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[5]朱晓晴,王宝珠,孙慧萍等.急性心肌梗死院内死亡危险因素分析[J].心血管康复医学杂志,2015,(2):148-153.
[6]Boucher JM,Racine N,Thanh TH,et al.Age related differences in hospital mortality and the use of thrombolytic therapy for a acute myocardial infarction.CMAJ,2001,164:1285-1291.
[6]Boucher JM,Racine N,Thanh TH,et al.Age related differences in in hospital mortality and the use of thrombolytic therapy for a acute myocardial infarction.CMAJ,2001,164:1285-1291.
[7]张春燕.急性心肌梗死住院患者病死率影响因素的Logistic回归分析[J].中国病案,2015,(10):54-55.
[8]华永平,龚素红,邓婷婷等.不同年龄老年急性心肌梗死住院患者近期预后分析[J].国际医药卫生导报,2013,19(13):1981-1982.DOI:10.3760/cma.j.issn.1007-1245.2013.13.034.
[9]景芳,熊日成,邓小玲等.护理干预对老年急性心肌梗死并多器官功能衰竭预后的影响[J].齐鲁护理杂志,2010,16(28):25-26.DOI:10.3969/j.issn.1006-7256.2010.28.016.
[10]Fravel M A,Mc Danel D L,Ross M B,et al.Special considerations for treatment of type 2diabetes mellitus in the elderly[J].Am J Health Syst Pharm,2011,68(6):500-509.
[11]Meier JJ,Deifuss S,Klamann A,et al.Plasma glucose at hospital admission and previous metabolic control determine myocardial infarct size and survival in patients with and without type 2 diabetes:the Langendreer Myocardial Infarction and Blood Glucose in Diabetic Patients Assessment(LAMBDA)[J].Diabetes Care.2005,28:2551–2553.
[12]杨金玲,李广平.青年急性心肌梗死临床特点与冠状动脉造影分析[J].临床荟萃,2014,(9):961-964.
[13]Mehta RH,Rathore SS,Radford MJ,et a1.Acute myocardial infarction in the elderly:differences by age[J].J Am Coll Cardio1,2001,38(3):736-741.
[14]石涤非.老年急性心肌梗死合并心力衰竭的预后[J].中国医药指南,2011,09(36):331-332.
[15]Park M,Sangean MC,Volpe Mde S,et a Z Randomized prospective trial of oxygen,continuous positive airway pressure,and bilevel positive airway pressure by face mask in acute cardiogenic pulmonary edema.Grit Care Med,2004,32(12):2407-2415.
[16]邹克勇.急性心肌梗死并发肺炎的病因及预后分析[J].中国当代医药,2014,21(14):53-54,58.国内外一些研究也发现女性急性心肌梗死患者预后较男性差,但多因素分析未证实女性是影响预后的独立危险因素L44 Bueno H,Vidan MT,alrnazan A,et a1.Influence of sex on the short—term outcome of elderly patients with a first acute myocardial infarction.Circulation,1995,92:1133—1140.
[2]金泽宁,陈韵岱,潘伟琦,等.不同治疗方式对老年急性ST段抬高心肌梗死的临床疗效分析.中国实用内科杂志,2008,5:399-351.
[3]Mamna AI,Goktekin U,Fiscella D,et al.Which strategy should be uesd for acute STelavation myocardial infarction in patients aged more than 75 years?J Cardiovascs Med,2006,7;388-396.
[4]范利,崔华,胡亦新等.不同年龄老年急性心肌梗死住院患者近期预后的临床分析[J].中华老年医学杂志,2009,28(3):190-192.
[5]朱晓晴,王宝珠,孙慧萍等.急性心肌梗死院内死亡危险因素分析[J].心血管康复医学杂志,2015,(2):148-153.
[6]Boucher JM,Racine N,Thanh TH,et al.Age related differences in hospital mortality and the use of thrombolytic therapy for a acute myocardial infarction.CMAJ,2001,164:1285-1291.
[6]Boucher JM,Racine N,Thanh TH,et al.Age related differences in in hospital mortality and the use of thrombolytic therapy for a acute myocardial infarction.CMAJ,2001,164:1285-1291.
[7]张春燕.急性心肌梗死住院患者病死率影响因素的Logistic回归分析[J].中国病案,2015,(10):54-55.
[8]华永平,龚素红,邓婷婷等.不同年龄老年急性心肌梗死住院患者近期预后分析[J].国际医药卫生导报,2013,19(13):1981-1982.DOI:10.3760/cma.j.issn.1007-1245.2013.13.034.
[9]景芳,熊日成,邓小玲等.护理干预对老年急性心肌梗死并多器官功能衰竭预后的影响[J].齐鲁护理杂志,2010,16(28):25-26.DOI:10.3969/j.issn.1006-7256.2010.28.016.
[10]Fravel M A,Mc Danel D L,Ross M B,et al.Special considerations for treatment of type 2diabetes mellitus in the elderly[J].Am J Health Syst Pharm,2011,68(6):500-509.
[11]Meier JJ,Deifuss S,Klamann A,et al.Plasma glucose at hospital admission and previous metabolic control determine myocardial infarct size and survival in patients with and without type 2 diabetes:the Langendreer Myocardial Infarction and Blood Glucose in Diabetic Patients Assessment(LAMBDA)[J].Diabetes Care.2005,28:2551–2553.
[12]杨金玲,李广平.青年急性心肌梗死临床特点与冠状动脉造影分析[J].临床荟萃,2014,(9):961-964.
[13]Mehta RH,Rathore SS,Radford MJ,et a1.Acute myocardial infarction in the elderly:differences by age[J].J Am Coll Cardio1,2001,38(3):736-741.
[14]石涤非.老年急性心肌梗死合并心力衰竭的预后[J].中国医药指南,2011,09(36):331-332.
[15]Park M,Sangean MC,Volpe Mde S,et a Z Randomized prospective trial of oxygen,continuous positive airway pressure,and bilevel positive airway pressure by face mask in acute cardiogenic pulmonary edema.Grit Care Med,2004,32(12):2407-2415.
[16]邹克勇.急性心肌梗死并发肺炎的病因及预后分析[J].中国当代医药,2014,21(14):53-54,58.国内外一些研究也发现女性急性心肌梗死患者预后较男性差,但多因素分析未证实女性是影响预后的独立危险因素L44 Bueno H,Vidan MT,alrnazan A,et a1.Influence of sex on the short—term outcome of elderly patients with a first acute myocardial infarction.Circulation,1995,92:1133—1140.