老年急性心肌梗死特点及急诊介入治疗近期疗效分析  

Characteristics of senile acute myocardial infarction and short-term curative effect of emergency PCI

作　　者：刘洋 刘恒亮 赵友民 白树鸣 郝冬琴 开芸 柴建文 刘灵芝 耿国英 

机构地区：[1]郑州市人民医院心内科,郑州450002

出　　处：《中国循证心血管医学杂志》2010年第2期92-94,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨急诊经皮冠状动脉介入治疗(PCI)对老年急性心肌梗死(AMI)的疗效和安全性。方法采用回顾性分析方法 ,将228例行急诊PCI的AMI患者分为老年组(n=116例)和非老年组(n=112例),分别对两组的临床特征、住院时间和并发症发生率进行比较。结果两组患者平均住院时间非老年组明显短于老年组(P<0.01);入院到球囊扩张平均时间两组间无显著性差异(P>0.05),老年组置入2个以上支架数、住院期间二次PCI和梗死后心绞痛明显高于非老年组(P<0.01),再梗死两组间无显著性差异(P>0.05),老年组严重心律失常和泵功能KillipⅢ级以上明显多于非老年组血(P<0.01),但两组间心源性休克的发生率和30d死亡率无显著性差异(P>0.05)。结论老年AMI行急诊PCI治疗并发症高于非老年患者,但并不增加近期死亡率。Objective To investigate the curative effect and safety in the treatment of senile acute myocardial infarction （AMI） with emergency percntaneous coronary intervention （PCI）. Methods The retrospective analysis was applied, and all AMI patients （n = 228 ） with emergency PCI were divided into senile group （n = 116） and non-senile group （n = 112）. The clinical features, hospitalized time and incidence of complications in two groups were compared. Results The average hospitalized time of the non-senile group was significantly shorter than that of the senile group （ P 〈 0.01 ）. The average time from hospitalization to balloon dilatation was not different between two groups （ P 〉 0.05 ）. In the senile group the numbers of more than two stents, PCI for two times in hospital and post-infarction angina were significantly higher than those in the non-senile group （ P 〈 0.01 ）. There was no significant deference in re-infarction between two groups （ P 〉 0.05 ）. The numbers of severe arrhythmia and over Killip Ⅲ of heart function were significantly higher in the senile group than those in the non-senile group （ P 〈 0.01 ）. There was no significant difference between two groups in the numbers of cardiogenic shock and mortality within 30 days （ P 〉 0.05 ）. Conclusion The incidence of complications was higher in senile AMI patients after emergency PCI than that in non-senile AMI patients, but the short-term mortality was not increased.

关 键 词：老年人 心肌梗死 经腔血管成形术 经皮冠脉介入治疗 急性病 预后 

分 类 号：R541.4[医药卫生—心血管疾病]