老年急性心肌梗死并心源性休克冠状动脉介入治疗的临床效果分析

Clinical Analysis of Elderly Acute Myocardial Infarction and Cardiogenic Shock after Coronary Intervention Treatment

目的:对比分析介入治疗和保守治疗对急性心梗合并心源性休克的老年患者的治疗效果。方法:回顾性分析急性心肌梗死并心源性休克患者,共入选230例,按照医生评估进行分组治疗,分为介入治疗组和非介入治疗组,介入组患者120例,接受冠脉介入治疗;非介入组患者110例,接受非介入治疗。对比分析危险因素以及治疗效果。结果:介入组中心肌梗死病史及心衰病史患者明显高于非介入组(24.2%vs 20%P<0.05;25%vs 17.3%,P<0.05),经皮冠状动脉介入治疗与非介入治疗相比能显著降低急性心梗合并心源性休克的老年患者住院病死率(40.8%vs 71.8%,P<0.05),非介入治疗组心律失常发生率高于介入治疗组(26.7%vs 21.8%,P<0.05),同时非介入治疗组肺部感染及肾衰的发病率较高(11.8%vs 5.8%P<0.05;8.2%vs 2.0%,P<0.05)。结论:针对急性心梗合并心源性休克的老年患者制定治疗方案时,虽然介入治疗存在更多的并发症,但是可以显著改善患者预后。

Objective： Comparative Analysis of interventional therapy and conservative treatment in elderly with cardiogenic shock complicating acute myocardial infarction.Methods： Retrospective analysis of elderly with cardiogenic shock complicating acute myocardial infarction was conducted in our hospital and 230 patients were enrolled.Patients were arranged to percutaneous coronary intervention group（PCI,120 patients） and conservative treatment group（CT,110 patients） according to the medical assessment of doctors.Then risk factors and efficacy of different treatment were analyzed.Results： History of myocardial infarction and history of heart failure were higher in conservative treatments group（24 % vs 20 % P〈0.05;25 % vs 17.3 %,P〈0.05）,PCI decreased fatality in elderly with cardiogenic shock complicating acute myocardial infarction（40.8 % vs 71.8 %,P〈0.05）.Meanwhile,conservative treatment group had more arrhythmia,lung infection and renal failure（26.7 % vs 21.8 %,P〈0.05;11.8 % vs 5.8 % P〈0.05;8.2 % vs 2.0 %,P〈0.05）.Conclusion： Although has more complications compared to conservative treatment,PCI may significantly improved the prognosis in elderly with cardiogenic shock complicating acute myocardial infarction.