急性非ST段抬高型心肌梗死患者临床特征和PCI决策影响因素:80～95岁住院患者  

Clinical characteristics and influence factors of PCI in octogenarians presenting with nonST-elevation myocardial infarction:hospitalized patients of 80-95 years old

作　　者：邹育海[1] 孔冉冉 洪长江[1] 向定成[1] ZOU Yuhai;KONG Ranran;HONG Changjiang;XIANG Dingcheng(Department of Cardiovascular Medicine,General Hospital of Guangzhou Military Commad of PLA,Guangzhou 510010,China)

机构地区：[1]广州军区总医院心血管内科,广东广州510010

出　　处：《分子影像学杂志》2018年第4期530-533,共4页Journal of Molecular Imaging

基　　金：国家自然科学基金(81500298);广东省医学科研基金(A2016292)

摘　　要：目的探讨80岁以上老老年急性非ST段抬高型心肌梗死(NSTEMI)患者的临床特征和经皮冠脉介入诊疗术(PCI)决策的影响因素。方法纳入2016年7月～2017年6月我院住院诊疗的63例老老年NSTEMI患者与同期71例中青年NSTEMI患者,观察两组患者的临床特征和PCI选择情况,分析影响PCI决策的相关因素。结果老老年组患者伴随高血压、肾功能不全、肺部感染、贫血的比例较中青年组升高(P<0.05);与中青年组相比,老老年组选择PCI术的比例明显降低(P<0.05);老老年组在住院期间总体抢救成功率低于中青年组(P<0.05);老老年组选择PCI治疗策略死亡率与中青年组差异无统计学意义(P>0.05),但药物保守治疗死亡率高于中青年组(P<0.05);多因素Logistic回归分析提示年龄、GRACE危险分层、心功能分级、伴随≥3个疾病是影响NSTEMI患者是否行PCI的独立相关因素。结论老老年急性NSTEMI患者病情复杂,合并疾病多,选择PCI术的比例下降;PCI有益于提高老老年急性NSTEMI患者的抢救成功率。Objective To investigate the Clinical characteristics and influence factors of PCI in Octogenarians presenting withnon-ST-elevation myocardial infarction. Methods We included 63 cases of very elderly patients （≥80 years old） diagnosedwith NSTEMI from July 2016 to June 2017 and 71 cases of young patients （〈 65 years old） confirmed NSTEMI at the sameperiod. The clinical characteristics and the selection ratio of PCI in two groups were compared. The relevant relevant influencefactor of PCI selection were explored. Results Hypertension, renal insufficiency, pulmonary infection and anemia in theelderly patients group was significantly higher than that of young group （P〈0.05）. The proportion of PCI in the very elderlygroup was significantly lower than that of young group （P〈0.05）. The overall rescue success rate in hospital of the very elderlygroup was significantly lower （P〈0.05）. No significant difference of mortality was found in the patients who selected PCI intwo group （P〉0.05）. The mortality in the patients who selected conservative medication in the very elderly group was higherthan that of young group （P〈0.05）. Age, GRACE risk stratification, heart function, more than 3 diseases were independentfactors of PCI selection in the NSTEMI patients. Conclusion The very elderly patients with acute NSTEMI are oftenaccompany with several diseases. They have low propotion of PCI selection and complex clinical features. PCI is beneficial toimprove the rescue success rate of the very elderly patients with acute NSTEMI.

关 键 词：老老年 急性非ST段抬高型心肌梗塞 冠脉介入诊疗术 临床特征 

分 类 号：R542.22[医药卫生—心血管疾病]