针对不同年龄阶段STEMI患者进行急诊PCI的临床疗效观察

Clinical Efficacy of Emergency PCI for Patients with STEMI at Different Age Stages

目的 探讨不同年龄阶段急性ST段抬高型心肌梗死(STEMI)患者行经皮冠状动脉介入治疗(PCI)的临床疗效,以根据年龄提供不同的诊疗建议。方法 选取夏邑县人民医院在2020年10月至2021年9月期间收治的87例STEMI患者,均接受PCI,根据年龄分成中青年组(年龄<60岁,n=41)、老年组(≥60岁,n=26)、高龄组(≥75岁,n=20),均接受随访,比较3组临床资料,比较术后1年心功能恶化发生率,通过单因素及多因素Logistic回归方程分析心功能恶化影响因素。结果 3组年龄、梗死血管开通时间、cTnI、BNP、HbA1c、MPV、Scr、LVEF比较,差异有统计学意义(P<0.05)。随访显示,中青年组有3例出现心功能恶化(7.32%),老年组4例心功能恶化(15.38%),高龄组7例心功能恶化(35.00%),差异有统计学意义(χ^(2)=7.643,P=0.022)。年龄、梗死血管开通时间、cTnI、BNP、MPV、LVEF是STEMI患者PCI术后心功能恶化独立危险因素,差异有统计学意义(P<0.05)。结论 STEMI患者PCI术后心功能恶化风险随着年龄增长而增加,主要与年龄、梗死血管开通时间、cTnI、BNP、MPV、LVEF等因素有关,需要对不同年龄段采取不同措施,以有效改善患者预后。

Objective To investigate the clinical efficacy of percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) at different age stages,in order to provide different diagnostic and treatment suggestions according to age.Methods 87 STEMI patients admitted to Xiayi County People’s Hospital from October 2020 to September 2021 were selected,all of whom underwent PCI.They were divided into the young and middle-aged group (age60 years,n=41),the elderly group (≥60 years old,n=26),and the old-aged group (≥75 years old,n=20) according to age.All were followed up,and the clinical data of the three groups were compared.The incidence of heart function deterioration one year after surgery was compared,and the influencing factors of heart function deterioration were analyzed by univariate and multivariate Logistic regression equations.Results There were significant differences in age,time of infarcted vessel opening,c TnI,BNP,HbA1c,MPV,Scr,LVEF among the three groups (P<0.05).Follow-up showed that there were 3 cases of heart function deterioration in the young and middle-aged group (7.32%),4 cases in the elderly group (15.38%),and 7 cases in the old-aged group (35.00%),with a significant difference (χ^(2)=7.643,P=0.022).Age,time of infarcted vessel opening,cTnI,BNP,MPV,LVEF are independent risk factors for heart function deterioration after PCI in STEMI patients,with a significant difference(P<0.05).Conclusion The risk of heart function deterioration after PCI in STEMI patients increases with age.It is mainly related to factors such as age,time of infarcted vessel opening,cTnI,BNP,MPV,LVEF.Different measures need to be taken for different age stages to effectively improve patient prognosis.