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目的探讨老年急性心肌梗死 (AMI)并发急性脑卒中的机理。方法回顾性分析 3 2 4例老年 AMI患者的临床资料。结果 2 2例脑卒中患者发生于左室前壁的心肌梗死 19例。心律失常组 15 6例中 ,发生脑卒中 17例 ;而对照组 168例心律基本正常者 ,发生脑卒中 5例。 18例患者收缩压持续低于 90 mm Hg(12 k Pa)超过 2 4小时 ,其中 4例发生了脑血栓形成。经超声心动图检查的 2 68例患者中发现有附壁血栓 48例 ,其中 8例发生了脑栓塞。结论老年 AMI并发急性脑卒中与心肌梗死部位、是否有严重心律失常、低血压、心脏附壁血栓等密切相关。
Objective To investigate the mechanism of acute stroke in elderly patients with acute myocardial infarction (AMI). Methods The clinical data of 324 elderly patients with AMI were retrospectively analyzed. Results Twenty-two cases of stroke occurred in 19 cases of myocardial infarction in the anterior wall of left ventricle. Among 15 6 cases of arrhythmia group, 17 cases of stroke occurred, while 168 cases of control group had normal heart rhythm and 5 cases of stroke. Eighteen patients continued to have systolic blood pressure less than 90 mm Hg (12 kPa) for more than 24 hours, of which 4 developed cerebral thrombosis. Forty-eight cases of mural thrombus were found in 288 cases of echocardiography, of which 8 cases had cerebral embolism. Conclusions The elderly patients with AMI complicated with acute stroke are closely related to myocardial infarction, severe arrhythmia, hypotension and mural thrombus.