补救性冠状动脉介入治疗经静脉溶栓失败后的老年急性心肌梗死患者的临床疗效及安全性研究  

The Clinical Efficacy and Safety Study of PCI Remedial Treatment after the Failure of Intravenous Thrombolytic Therapy in the Aged Patients with AMI

作　　者：危小军[1] 谢东阳[1] 廖伟[1] 钟一鸣[1] 谢东明[1] 周爱琴[1] 贺敏[1] 

机构地区：[1]赣南医学院第一附属医院心血管内科,江西赣州341000

出　　处：《赣南医学院学报》2010年第1期26-28,共3页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：2007年赣南医学院重点科研立项课题

摘　　要：目的:探讨补救性冠状动脉介入(PCI)治疗经静脉溶栓失败后的老年急性心肌梗死(AMI)患者的临床疗效及安全性。方法:≥65岁急性ST段抬高的急性心肌梗死(STE-AMI)患者26例(B组,≥65岁组),急诊静脉溶栓治疗后若梗死相关动脉(IRA)未能有效开通,即行冠状动脉造影(CAG),若IRA血流未达心肌梗死试验性溶栓TIMI3级,且仍有较明显胸痛和(或)梗死对应心电图导联ST段抬高,并除外急诊PCI禁忌证,即行IRA的补救性PCI。同时与<65岁的33例(A组,<65岁组)STE-AMI患者进行比较。结果:与A组患者比较,B组患者经静脉溶栓后行CAG显示:溶栓有效开通比例较低,但IRA经PCI治疗的成功比例两组无显著差异,B组PCI术后颅内出血、消化道大出血等主要并发症无明显增加。结论:补救性PCI治疗经静脉溶栓失败后的老年AMI患者具有显著的临床疗效和较高的安全性。Objective： To evaluate the efficacy and safety of PCI remedial treatment after the failure of intravenous thrombolytie therapy in the aged patients with acute myocardial infarction （AMI）. Methods： 59 patients with acute ST- segment elevation acute myocardial infarction （STE-AMI） were devided into 2 groups according to the age：group A （ 〈 65 years） and group B（ ≥65 years）. If the infarct - related artery （IRA） failed to effectively open after thrombolytic therapy, coronary angiography （CAG） would be carried out. If the IRA blood flow during the CAG was below TIMI 3 level, and there were still more obvious chest pain and （or） the ST-segment elevation in the ECG leads corresponding to infarction, the PCI remedial treatment on IRA was completed except for emergency PCI contraindication. The effective opening ratio of thrombolytic therapy, PCI treatment success ratio and complications were compared between two groups. Results： Compared with group A, the effective opening ratio of thrombolytic therapy in group B was lower, but PCI treatment success ratio after the failure of intravenous thrombolytic therapy was no significant difference between two groups. The major complications after PCI such as intracranlal hemorrhage, gastrointestinal bleeding and so on didn＇ t increased significantly in Group B. Conclusion： PCI remedial treatment after the failure of intravenous thrombolytic therapy has significant clinical efficacy and safety in the aged patients with AMI.

关 键 词：补救性PCI 老年 急性心肌梗死 临床疗效及安全性 

分 类 号：R542.2[医药卫生—心血管疾病]