青年与中老年急性心肌梗死患者急诊冠脉介入治疗临床疗效分析

Comparison of effects of primary percutaneous coronary intervention treatment between young patients and middle-old ones with acute myocardial infarction

目的探讨经皮冠状动脉介入(PCI)治疗对青年与中老年急性心肌梗死(AMI)患者的临床效果。方法选取我院102例AMI并行急诊PCI患者,分为青年组(≤46岁)与中老年组(>46岁),对两组患者在发病后24 h内进行直接PCI治疗,分析比较两组患者的临床疗效。结果两组手术成功率差异无统计学意义(100%vs 96.8%,P>0.05);青年组手术并发症(2.6%vs12.6%)、住院天数(8.2±0.9 vs 18.5±2.1)均低于中老年组,差异有统计学意义(P<0.05);住院期间心功能恢复较中老年组好(54.2±4.5%vs 46.2±2.8%),差异有统计学意义(P<0.05),术后2个月主要心血管事件发生率(5.3%vs 15.6%)及再住院率(7.9%vs 20.3%)青年组明显低于中老年组,差异有统计学意义(P<0.05);但两组的病死率差异无统计学意义(P>0.05)。结论急诊冠脉介入治疗对青年组与中老年组AMI疗效确切,但青年人疗效较中老年人更明显,预后更好。

Objective To compare the effects of primary percutaneous coronary intervention (PCI)in treating the young patients to the middle-old ones with acute myocardial infarction (AMI).Methods Totally 102 patients with AMI hospitalized from October 2007 to Oc-tober 2013 were enrolled and divided into young group (≤46years,n=38)and middle-old group (>46years,n=64);all were treated with PCI.The effects of the primary PCI between the two groups were analysed,meanwhile the related influence factors were compared.Results The success rate of PCI was high for both groups and there was no difference between the two groups (100%vs 96.8%,P>0.05).However, the combination of the PCI was less (2.6%vs 12.6%,P<0.05)and the average hospitalization time (8.2 ±0.9 vs18.5 ±2.1,P<0.05) was shorter,the left ventricular ejection fraction was higher (54.2 ±4.5% vs 46.2 ±2.8%,P<0.05 )in young group than in middle-old group.Moreover,the incidence of major cardiovascular events (MACCE)(5.3% vs 15.6%,P<0.05)and readmission rates(7.9% vs 20.3%,P<0.05)were significantly lower in young group after two months'follow-up.Conversely,the risk factors were more frequent and the lesions of coronary artery were more serious in the middle-old group,and the time from the onset of AMI to hospitalization or initiation of PCI for the young patients was less than old ones.Conclusion The effects of primary PCI is obvious for both young and middle-old patients with AMI,but more significant in the young people compared to middle-old ones.