高龄急性ST段抬高性心肌梗死急诊介入治疗的临床疗效观察

Study of the clinical efficacy of primary percutaneous coronary intervention for acute ST elevation myocardial infarction in the very elderly

目的评价高龄(年龄≥75岁)急性ST段抬高性心肌梗死(AMI)患者急诊经皮冠状动脉介入(PCI)治疗的临床疗效。方法对符合条件的高龄急性ST段抬高心肌梗死患者行急诊PCI治疗。患者入院后经临床和心电图诊断符合世界卫生组织提出的AMI诊断标准。结果 106例患者接受直接PCI术,梗死相关血管:前降支86支,回旋支4支,右冠状动脉16支。106支梗死相关动脉,成功开通102例,于球囊扩张后置入支架110枚,2例术中死于心源性休克。术后即刻造影成功率为98.5%,手术操作成功率为98%。术后1例住院期间死于心脏破裂。梗死后1周的平均左室射血分数为(51.2±3.3)%。结论急诊PCI治疗对高龄ST段抬高心肌梗死患者是安全有效的。

Objective To study the elinieal efficacy of primary pereutaneous coronary interventions （PCI） for acute ST segment elevation myocardial infarction （STEMI） in the very elderly （age≥75 years）. Methods 106 patients （ satisfied with the diagnosed criteria of AMI of WHO） were enrolled and reeeived primary PCI. Results Infarction related artery ineluded 86 left anterior deeending arteries （LAD） , 4 left circumflex arteries （LCX） , and 16 right coronary arteries （RCA）. Among the 106 IRAs, 102 IRAs received PCI successfully, and 110 stents were implanted in such IRAs. 2 patients died from cardiogenous shock dur/ng the procedure. After the procedures, instant angiography showed that 98.5% IRAs were patent, and 98% primary PCIs got success. After the procedure, 1 patient died from cardiac rapture. One week after the infaretion, mean left ventrieular eject fraction （LVEF） of all the patients were （51.2 ± 3.3 ） %. Conclusion Primary PCI could more rapidly and efficiously restore the blood flow in IRA, reduee in - hospital mortality of AMI, improve left ventrieular systolic function.