摘要
目的探讨急性心肌梗死(AMI)患者出现短暂精神障碍的临床特点及预后。方法2002年9月~2006年5月共有462例AMI后存活患者入选,年龄26~92岁,男252例,女210例,ST段抬高性心肌梗死(STEMI)271例、非ST段抬高性心肌梗死(NSTEMI)191例。统计分析并发精神障碍类型、主要临床表现、出现及持续的时间、转归及预后。分析比较不同性别、年龄、心肌梗死类型患者精神障碍发生情况。结果82例(17.7%)患者住院期间出现短暂精神障碍,年龄62~92岁。不同性别患者精神障碍发生率无显著性差异(P>0.05),不同梗死类型发生率有显著性差异(STEM发生率22.5%,NSTEM发生率11.0%,P<0.01)。患者精神障碍多在AMI发病后30min内出现,表现为意识障碍、情感障碍或妄想性障碍,持续2~10d,常突然好转,精神基本转为正常。门诊或电话随访3个月无1例复发。所有患者住院期间无1例死亡。结论急性心肌梗死患者可合并短暂精神障碍,老年人多见。STEMI发生率显著高于NSTEMI患者。可以自然缓解,预后未发现有不良倾向。
Objective:To study the clinical characters and prognosis of transient mental disorder in patients with acute myocardial infarction(AMl).Methods:From Sep.2002 to Mar.2006,462 AMI patients,aging from 26 to 92 years old,were enrolled.To survey the type,the time of incidence and persistence, the turnover and the prognosis of the mental disorder after AMI.To compare the incidence rate of transient mental disorder after AMI between male and female,STEMl and NSTEMI,and age difference.Results:Transient mental disorder occurred in 82 of all patients,aging from 62 to 92 years old,the total incidence rate of transient mental disorder was 17.7%,40 female,42 male, 61cases of STEMI and 21 cases of NSTEMI and the incidence rate of transient mental disorder were 19.0%,16.7%, 22.5% and 11.0% respectively.There was no significant variance of incidence rate between male and female (P〉0.05),whereas, the variance between STEMI and NTSEMI was significant (P〈0.01).The symptoms of mental disorder often occurred within 30 minutes after AMI,manifesting as conscious disturhance,affective disturbance or delusional disorder.The mental disorder often lasted for 2 to 10 days,then,took a favorable turn to normal abruptly.No recurrence happened during the 3 months followed up by telephone or out-patient clinic, and nobody died during the hospital stay.Conclusion:The patients with AM] may complicate transient mental disorder, the old is more susceptible,the incidence rate have no significant variance between female and male,whereas the variance is significant between STEMI and NSTEMI.The mental disorder can relieve naturally, and no bad tendency of the prognosis is observed at present.
出处
《中日友好医院学报》
2007年第3期147-149,共3页
Journal of China-Japan Friendship Hospital
关键词
急性心肌梗死
精神障碍
acute myocardial infarction
mental disorder