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探讨老年人扩张型心肌病（DCM）的临床特征并与青年人DCM进行比较。通过临床观察对80例老年人和140例青年DCM的临床资料进行对比分析。结果发现：（1）老年组醛固酮值（304.8±69.1）较青年组（213.3±54.5，pmol/L）明显增高（P<0.05），老年组T3和FT3值（0.78±0.21，2.87±0.73）较青年组（1.26±0.33 nmol/L，3.55±0.64 pmol/L）明显降低（均为P<0.01）；（2）老年组室性心律失常发生率（61.3％）较青年组（92.1％）低（P<0.01）；（3）老年组低血钾、低血镁发生率高（分别为51.3％和27.5％），对洋地黄敏感性增加，易发生洋地黄中毒（28.8％）；（4）老年组的病程［（11.0±4.7）年］和平均生存期［(6.9±4.2)年］均较青年人［(5.2±2.5)和（3.4±2.7）年］长（均为P<0.05）；（5）老年组的主要死因是充血性心力衰竭（78.9％），青年组则为恶性心律失常（61.9％）。结论为老年人DCM的预后比青年人相对要好;老年人DCM常伴低T3综合征;心力衰竭、电解质失衡及交感神经兴奋是老年人DCM室性心律失常的主要原因。“,”To study the clinical characteristics of dilated cardiomyopathy (DCM) in the elderly and the younger. The clinical data of DCM in 80 elderly and 140 younger cases were comparatively analyzed through clinical observations. Aldosterone in the elderly with DCM was higher than that in the younger［(304.8±69.1) pmol/L vs（213.3±54.5）pmol/L，（P<0.05）］.T3 and Free T3 in the elderly with DCM were lower than that in the younger ［(0.78±0.21) nmol/L，（2.87±0.73）pmol/L vs （1.26±0.33）nmol/L，（3.55±0.64）pmol/L，（all P<0.05）］.The incidence of ventricular arrhythmia in the elderly was lower than that in the younger （61.3％ vs 92.1％，P<0.01）。Incidences of hypokalemia and hypomagnesiemia were higher in the elderly（51.3％ and 27.5%）.The old patients were apt to digitalis in toxication due to the sensitivity to digitalis increased（28.8％）.Course of disease and mean survival period in the elderly with DCM was longer than that in the younger［(11.0±4.7)yrs and（6.9±4.2）yrs vs（5.2±2.5）yrs and（3.4±2.7）yrs，（all P<0.05）］. The main cause of death was congestive heart failure in the elderly with DCM（78.9％）and ventricular arrhythmia in the younger（61.9％）.The prognosis in the elderly with DCM was better than that in the younger,the earlier the age of onset, the worse the prognosis.DCM in the elderly are usually accompanied with Low T3 Syndrome. The main reasons of ventricular arrhythmia in the elderly were heart failure, electrolyte imbalance and sympathetic excitation.