Yoshimura A, Saikawa T, Takakura T, Takeshita Y, Maeda T, Koumatsu K, Inoue T
First Department of Internal Medicine, Oita Medical University.
J Cardiol. 1995 Mar;25(3):113-8.
Recently, the prevalence of acute myocardial infarction (AMI) in the elderly patients has increased. The clinical features have not been extensively studied, so this study attempted to clarify the clinical course and prognosis of elderly patients with AMI. The patients were divided into two groups, those over 80 years old and those between 60 and 79 years old. The clinical symptoms, electrocardiographic findings, complications, and short-term prognosis were compared. The serum lipid levels were compared between the AMI groups and age-matched control groups consisting of subjects without sclerotic heart disease. There was no significant difference in clinical symptoms between the two groups, electrocardiographic findings, incidence of complications, and mortality. The total cholesterol and LDL cholesterol levels, and atherogenic index were significantly higher in the 60-79 years old AMI group, but no significant difference was observed in the 80 years and over AMI group compared to the control group. The HDL cholesterol level of the 60-79 years old AMI group was significantly lower, but no significant difference was observed in the 80 years and over group. There was no significant difference in triglyceride level in either AMI group. Therefore, in patients aged 60-79 years hyperlipidemia is a risk factor for ischemic heart disease, but the relationship between serum lipid and AMI is not positively established in patients older than 80 years. These results suggest that the significance of hyperlipidemia in patients over 80 years old should be reconsidered.
近年来，老年患者急性心肌梗死（AMI）的患病率有所上升。其临床特征尚未得到广泛研究，因此本研究试图阐明老年AMI患者的临床病程及预后。将患者分为两组，80岁以上组和60至79岁组。比较两组的临床症状、心电图表现、并发症及短期预后。比较AMI组与由无硬化性心脏病受试者组成的年龄匹配对照组的血脂水平。两组在临床症状、心电图表现、并发症发生率及死亡率方面无显著差异。60至79岁AMI组的总胆固醇和低密度脂蛋白胆固醇水平以及致动脉粥样硬化指数显著更高，但80岁及以上AMI组与对照组相比无显著差异。60至79岁AMI组的高密度脂蛋白胆固醇水平显著更低，但80岁及以上组无显著差异。两组的甘油三酯水平均无显著差异。因此，在60至79岁的患者中，高脂血症是缺血性心脏病的危险因素，但在80岁以上的患者中，血脂与AMI之间的关系尚未明确确立。这些结果表明，应重新考虑80岁以上患者高脂血症的意义。
