摘要
目的分析75岁以上高龄ST段抬高急性心肌梗死(STEM I)急诊经皮冠状动脉介入治疗(PC I)患者住院期间的临床特征和术后12个月的随访结果。方法回顾性分析2005年3月至2010年3月,实行急诊PC I术的STEM I患者297例,年龄(59.33±11.42)岁,将高龄组(≥75岁)患者49例的临床特征、治疗结果和预后与对照组(<75岁)患者进行对比。结果高龄组患者占16.5%,年龄(77.46±2.37)岁,其中女性患者比例高于对照组(34.7%比19.8%,P<0.05)。高龄患者既往陈旧心梗、卒中较对照组多,分别是(18.3%比7.7%;30.6%比10.8%;P<0.05);其缺血时间较对照组长(4.66±2.49)h比(3.76±2.05)h,左室射血分数低(52.88±6.70)%比(55.66±7.51)%,P<0.01;高龄组冠脉介入手术成功率、并发症发生率与对照组差异无统计学意义,分别是(93.9%比97.2%,4.1%比2.0%),P>0.05;高龄组患者病变复杂,三支血管病变、术中再灌注心律失常发生率高于对照组,分别为(38.7%比23.5%;44.8%比28.6%,P<0.05)。住院期间和术后12个月两组患者在死亡、再梗死、卒中及靶血管重建率方面差异无统计学意义,术后12个月高龄组总体MACE高于对照组(22.4%比7.2%),P<0.05。结论尽管高龄组患者术后12个月的总体MACE高于对照组,但在手术成功率、并发症发生率、死亡、再梗死、卒中及靶血管重建率方面相似,急诊PC I是年龄≥75岁的高龄STEM I患者安全、有效的再灌注治疗策略。
Objective To analyze the clinical characteristics and prognosis of primary percutaneous coronary intervention（PCI） in patients ≥75 years old with ST-segment elevation acute myocardial infarction（STEMI） during hospitalization and after 12 months.Methods A retrospective analysis of 297 STEMI patients undergoing primary PCI admitted between March 2005 to March 2010（mean age 59.33 ± 11.42 years） was done.The clinical characteristics,treatment results and prognosis of the elderly group（≥75 years,n=49） were compared with the control group（n=248）.Results The elderly group accounted for 16.5% of patients with mean age（77.46±2.37） years.The elderly group consisted more female patients than in the controls（34.7% vs.19.8%,P0.05）.Elderly patients were more frequently to have old myocardial infarction and stroke（18.3% vs.7.7%;30.6% vs.10.8%;P0.05,respectively）;as well as long ischemic time（4.66±2.49） h vs.（3.76±2.05） h,and low LVEF（52.88±6.70）% vs.（55.66±7.51）%,P0.01.Coronary intervention success rate of the elderly group compared with the control was（93.9% vs.97.2%,P0.05） and complication rate was（4.1% vs.2.0%,P0.05）.Complex lesions,multi-vessel disease,reperfusion arrhythmias of the elderly group was much higher than the control group（38.7% vs.23.5 %;44.8% vs.28.6%,P0.05,respectively）.The incidence of in-hospital death and death after 12 months,reinfarction,stroke,target vessel revascularization respectively were similar in both groups.Overall MACE increased in the elderly group after 12-month（22.4% vs.7.2%;P 0.05）.Conclusions Although incidence of elderly group in overall MACE after 12 months was higher,the success rate of surgery,complication rate,death,reinfarction,stroke,target vessel revascularization respectively were similar in both group.Primary PCI is a safe and effective strategy for reperfusion therapy in elderly patients.
出处
《中国介入心脏病学杂志》
2011年第5期257-260,共4页
Chinese Journal of Interventional Cardiology
关键词
发病年龄
心肌梗死
血管成形术
经腔
经皮冠状动脉
预后
Age of onset
Myocardial infarction
Angioplasty
transluminal
percutaneous coronary
Prognosis
