老年急性心肌梗死患者冠状动脉内支架置入术的临床疗效观察

Clinical efficacy of coronary stenting in elderly patients after acute myocardial infarction

目的 评价老年急性心肌梗死 (AMI)患者梗死相关动脉支架置入术的安全性和有效性。方法 对34例年龄≥ 6 0岁的老年AMI患者在发病 12小时以内行梗死相关动脉直接经皮冠状动脉腔内成形术 (PTCA)加冠状动脉内支架置入术。结果 34例患者梗死相关动脉共置入支架 4 0个 ,术中死于心源性休克 1例 ,手术成功率97.1% (33/ 34)。术后TIMI血流 3级为 31例 (91.2 % )。住院期间死亡 1例 ,死于肾功能衰竭。临床总成功率为94 .1% (32 / 34)。随访 2 9例 ,1例出现心绞痛 ,心血管造影证实为再狭窄 ,行切割球囊成形术。结论 老年AMI患者梗死相关动脉PTCA加支架置入成功率高 ,并发症低 ,近期临床疗效确切。

Objective To evaluate the clinical efficacy of primary intracoronary stenting in the infarctrelated artery in elderly patients after acute myocardial infarction(AMI).Methods Percutaneous transluminal coronary angioplasty (PTCA)plus pimary coronary stenting was performed for 34 AMI patients(≥60 years)within12 hours from the onset of chest pain.Results Forty stents were implanted in the infarct-relate for 34 patients.One patient died of cardiac shock during the procedure,and ,the success rate was 97.1%(33/34).Grade 3 of blood flow after TIMI was gained in 31 patients(91.1%).One patient died of renal failure while hospitalizing.The clinical successful rate was 94.2% (32/34).Twenty-nine patients were followed up,1 patient with restenosis of infarct-related artery was parformed cutting balloon angioplasty. Conclusion Primary coronary stenting for the infarct-related artery in elderly patients after AMI is safe and effective with a high successful reat and less complications.