高龄急性心肌梗死患者直接PCI治疗的安全性及近期疗效分析  

Efficacy and safety of primary percutaneous coronary intervention for acute myocardial infarction in elderly patients

作　　者：潘国忠[1] 马志敏[2] 胡大一[2] 杨明[1] 李田昌[1] 高亢[1] 岑强[1] 韩凌[1] 

机构地区：[1]首都医科大学附属复兴医院心脏中心 [2]首都医科大学北京附属北京同仁医院心血管中心

出　　处：《中国心血管病研究》2006年第5期334-336,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨高龄(75岁以上)急性心肌梗死(AMI)患者行直接冠状动脉介入治疗(PCI)的安全性及住院期间的预后。方法将连续247名接受直接PCI治疗的ST段抬高的AMI患者分为3组:≥75岁为高龄组(研究组,63例),65～74岁(老年组,80例)及<65岁(低龄组,104例)患者为对照组,比较高龄组及两个对照组患者接受直接PCI治疗的安全性及住院期间的预后。结果高龄组患者的外周血管严重病变、冠状动脉多支病变及钙化弥漫性病变多于两个对照组,但三组PCI治疗的成功率相当(分别为90.5%、93.8%和95.2%,P>0.05);高龄组患者PCI后24h内肾功能恶化的发生率显著高于对照组;高龄组患者住院期间严重心血管事件(死亡、再梗死)的发生率较高(分别为12.7%、7.5%、2.9%,P=0.02)。大出血发生率差异无统计学意义。结论ST段抬高的高龄AMI患者直接行PCI治疗安全可行;但近期疗效略逊于低龄患者。Objective To investigate the safety and short term prognosis of the elderly patients （≥75 years old） with ST- elevation myocardial infarction （STEMI） undergoing primary percutaneous coronary intervention（PCI）. Methods The therapeutic results of primary PCI in the elderly were assessed in 63 patients （range 75-89 years, mean 78.50±8.16） with STEMI and the results were compared with 80 patients aged 65-74years old and 104 patients younger than 65 years who underwent primary PCI during the same period. Results Primary PCI was successful in 90.5% of the elderly group, in 95.2% of the younger group. No significant difference between the elderly and the younger groups. However, in-hospital mortality was higher in the elderly group than in the younger group, （12.7% versus 2.9%, P〈0.01）. Conclusion Our results suggest that primary PCI is safe and has high success rate in the elderly patients with STEMI. Although the in-hospital mortality is higher in the elderly patients than in the younger, the total mortality is lower.is lower.

关 键 词：心肌梗塞 血管形成术 经腔 经皮冠状动脉 预后 

分 类 号：R542.22[医药卫生—心血管疾病]