老年不典型急性心肌梗塞患者的临床特点 及其治疗方法与效果

李轩

西安市高陵区医院，陕西 西安，710200

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摘要：

目的 研究老年不典型急性心肌梗塞患者的临床特征及其治疗方法与效果。方法 对本院 2015年 12月至 2016年 12月我院接诊的 60例老年不典型急性心肌梗塞患者的病例资料进行回顾性分析，以全面了解其临床特征，并以不同的治疗方案为分组依据，将患者分为 A 组（n=30）实施阿司匹林联合氯吡格雷治疗和 B 组（n=30）实施单纯阿司匹林治疗。观察并比较两组的临床疗效。结果 两组患者的临床表现主要为消化系统症状、心力衰竭、休克、疼痛、单纯心律失常与脑血管疾病等。A 组患者的血管再闭塞率明显比 B 组低，差异显著（P＜0.05）。治疗后，两组患者的 APTT 延长，PAR 降低，且 A 组的各项指标均优于 B 组（P＜0.05）。结论 临床应特别加强对老年不典型急性心肌梗死病患的临床特征的研究力度，进而联合心肌酶谱与心电图等检查手段明确患者的病情；对患者施以阿司匹林联合氯吡格雷治疗，可取得比单纯阿司匹林治疗方案更好的成效。

关键词： 临床特征；不典型急性心肌梗塞；氯吡格雷

中图分类号：R542.22文献标志码：A文章编号：2096-1413(2018)09-0036-02

Clinical features of atypical acute myocardial infarction in elderly patients and
its treatment methods and effects

LIXuan
(Xi````an GaolingHospital,Xi````an 710200,China)




ABSTRACT: Objective To study the clinical features of atypical acute myocardial infarction in elderly patients and its treatment methods and effects. Methods A retrospective analysis was performed on the data of 60 elderly patients with atypical  acute myocardial infarction admitted in our hospital from December 2015 to December 2016 to fully understand atypical acute myocardial infarction````s clinical features. Patients were divided into group A (n=30)for aspirin plus clopidogrel and group B (n=30)for aspirin alone based on different treatment regimens.The clinical efficacy of both groups was observed and compared. Results The clinical manifestations of the two groups were mainly digestive system symptoms,heart failure,shock,pain,simple arrhythmia and cerebrovascular disease.The rate of vascularreocclusion in the group A was significantly lower than that in the group B (P<0.05).After treatment,the APTT prolonged and PAR decreased in both groups,and the indexes in the group A were better than those in the group B (P<0.05). Conclusion The clinical characteristics of elderly patients with atypical acute myocardial infarction should be paid more special attention,and clearthe patients````condition with myocardial enzymes and other means of examination of ECG;then patients receiving aspirin and clopidogrelw treatment can achive better results than aspirin treatment alone.
KEYWORDS: clinical features;atypical acute myocardial infarction; clopidogrel


参考文献：
[1] 戚增明,吴晓杰,杨玉婷,等.老年人不典型急性心肌梗塞的临床特征分析及治疗体会 [J]. 中西医结合心血管病电子杂志 ,2015,3(35):46-47.
[2] 陈谷,老年人急性心肌梗塞 36 例临床分析 [J].世界临床医学 ,2016,10(2):17.
[3] 吾买尔江,依不拉音,热娜古丽·艾则孜.老年人不典型急性心肌梗塞的临床特征分析及治疗体会 [J]. 中西医结合心血管病电子杂志 ,2016,4(24):79,82.
[4] 倪雯.急性心肌梗死不典型心电图 40 例临床分析 [J].医学信息,2015,28(4):363-364.
[5] 许文举,林艳足,庄丽,等.氯吡格雷联合阿司匹林治疗急性心肌梗死的疗效 [J].广东医学 ,2012,33(11):1665-1666.
[6] 张永强.氯吡格雷联合阿司匹林治疗急性心肌梗死的疗效及安全性分析 [J].医药前沿 ,2017,7(5):240-241.