老年急性心肌梗死急诊冠状动脉介入治疗分析

The clinical analysis of the treatment of percutaneous coronary intervention in the elderly patients with acute myocardial infarction

目的评价急诊经皮冠状动脉介入治疗(PCI)对老年性急性心肌梗死(AMI)的临床疗效。方法对我院1997年12月至2004年12月接受急诊PCI治疗大于60周岁的AMI患者72例(PCI组),同期病年龄大于60周岁未行急诊PCI治疗的AMI患者中随机抽取70例(对照组),比较两组住院和随诊期间不良心血管事件(再发心绞痛、心肌梗死、猝死)的发生率。结果PCI组72例住院死亡7例、左室射血分数(LVEF)(33.4±4.2)%、平均住院天数20.3(19.2±1)d,随诊期间再发心绞痛16例、猝死1例。对照组70例住院死亡16例、LVEF(28.8±9.3)%、平均住院天数27.4(25.1±6.3)d,随诊期间再发心绞痛39例、心肌梗死6例、猝死5例。结论急诊PCI治疗能较好地提高老年心肌梗死抢救成功率、缩短住院天数,减少心血管事件的发生率。

Objective To evaluate the effectiveness of emergency percutaneous coronary intervention（PCI） on the elderly patients with acute myocardial infacrion（AMI）. Methods All the patients with age oiler than 60 years old were diagnosed definitely as AMI during December 1997 and December 2004. And all the elderly patients with AMI were randomly received by the therapy of emergency PCI （PCI group,n = 72 ） and traditional medicine （contrast group, n=70）. Then compare the rates of major reverse cardiac event in-hospital and in follow-up time. Results In PCI group 7 patients died, the average LVEF was （33.4 ±4.2）% and the average in-hospital day was 20.3（ 19.2± 1）. While 6 patients had angina pecroris again and one patient suffered sudden death in follow-up time. In coarrast group 16 patients died,the average LVEF was （28.8± 9.3） % and the average in-hospital day was 27.4 （25.1±6.3）. While 39 patients had angina pectoris, 6 patients suffered infarction again and 5 patients suffered sudden death in follow-up time. Conclusion Emergency PCI can improve the effectiveness.shorten the in-hospital day and reduce the major reverse cardiac event of the elderly patients with AMI.