老年急性心肌梗死患者急诊介入治疗的近期疗效分析  

Short-term therapeutic effect of emergency PCI in elderly patients with acute myocardial infarction

作　　者：刘洋[1] 刘恒亮[1] 耿国英[1] 巴宁[1] 荆松宾 郭微[1] 张志芳[1] 

机构地区：[1]郑州人民医院心内科,450002

出　　处：《中华老年心脑血管病杂志》2012年第6期587-589,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：郑州市创新型科技人才队伍建设项目(096SYJH33114)

摘　　要：目的探讨急诊PCI对老年急性心肌梗死(acute myocardial infarction,AMI)患者的疗效和安全性。方法选择接受急诊PCI的AMI患者351例,分为老年组273例,高龄组78例。比较2组的临床资料、冠状动脉病变特征、住院时间和并发症的发生率。结果老年组单支病变明显高于高龄组,双支、3支病变及合并左主干病变明显低于高龄组(P<0.05,P<0.01)。高龄组置入2个以上支架数、住院期间择期再次PCI、梗死后心绞痛、严重心律失常和≥KillipⅢ级心功能发生率明显高于老年组(P<0.05,P<0.01);2组住院时间、入院到球囊扩张时间、住院期间再梗死、心源性休克发生率和30 d病死率比较,差异无统计学意义(P>0.05)。结论高龄AMI患者行急诊PCI治疗是安全有效的。Objective To study the therapeutic effect and safety of emergency percutaneous coronary intervention（PCI）in elderly patients with acute myocardial infarction （AMI）. Methods Three hundred and fifty-one AMI patients who underwent emergency PCI were divided into senile group aged 60--79 years（n=273）and elderly group aged≥80 years（n= 78）. Their clinical data, coronary angiographic characteristics, hospital stay time and complications were compared. Results The incidence of single vessel lesion was significantly higher while the incidence of double vessel lesion and triple vessel lesion involving the left branch was significantly lower in senile group than in elderly group（P〈0.05,P〈0.01）. The number of patients who underwent implantation of more than two stents and second PCI, and the incidence of angina pectoris after AMI, severe arrthymia and heart failure≥Killip III were significantly higher in elderly group than in senile group （P〈0.05,P〈0.01）. However,no significant difference was found in hospital stay time,average time from admission to balloon dilation, incidence of recurrent AMI and cardiogenie shock, and 30- day mortality between the two groups（P〉0.05）. Conclusion Emergency PCI is a safe and effective modality for elderly patients.

关 键 词：心肌梗死 急症 冠状动脉疾病 支架 住院时间 治疗结果 

分 类 号：R542.22[医药卫生—心血管疾病]