老年急性ST段抬高型心肌梗死患者急诊治疗策略选择及预后分析

Emergency Treatment Strategy Selection and Prognosis Analysis on Elderly Patients with Acute ST-segment Elevation Myocardial Infarction

目的探讨老年急性ST段抬高型心肌梗死(STEMI)患者急诊治疗策略的选择及其预后情况。方法选取134例老年STEMI患者为研究对象,根据年龄的不同分为A组57例(55~64岁)、B组45例(65~74岁)和C组32例(≥75岁),比较3组患者的急诊治疗策略,并对不同治疗策略患者的预后情况进行分析。结果组间比较,3组患者在治疗前Killip分级、选择未再灌注治疗人数及不良预后发生率方面差异均有统计学意义(P<0.05);不同急诊策略下,急诊经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)患者中不良预后21例(38.18%),急诊溶栓患者中不良预后11例(68.75%),未再灌注治疗患者中不良预后42例(66.67%),组间比较,不同急诊治疗策略下患者不良预后发生率差异无统计学意义(P>0.05)。结论再灌注治疗是老年STEMI患者的首选治疗策略,其中急诊PCI为优选治疗策略,相比溶栓治疗更加安全有效。

Objective To explore the options and prognosis of emergency treatment strategies for elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Methods 134 patients with STEMI were selected as subjects.According to age,57 patients(55-64 years old)in group A,45 patients(65-74 years old)in group B,and 32 patients(≥75 years old)in group C were included.The emergency treatment strategies of the three groups of patients were compared,and the prognosis of patients after different treatment strategies was analyzed.Results The comparison between groups showed that the differences of Killip classification before treatment,the number of patients without reperfusion therapy,and the incidence of adverse prognostic between the three groups were statistically significant(P<0.05).Under different emergency treatment strategies,there were 21 cases(38.18%)of patients with emergency PCI,11 cases(68.75%)of patients with emergency thrombolysis,and 42 cases(66.67%)of patients without reperfusion.There was no statistically significant difference in the incidence of adverse prognosis among patients with different emergency treatment strategies(P>0.05).Conclusion The reperfusion therapy is the first choice for elderly patients with STEMI,and the emergency PCI is optimizing treatment strategies,which is more safe and effective comparing with thrombolysis treatment.