摘要
目的:评价急诊经皮冠状动脉介入治疗(PCI)和静脉溶栓治疗对老年急性心肌梗死预后的影响。方法:我科203例老年AMI患者,32例患者接受常规治疗(对照组),98例接受静脉溶栓治疗(溶栓组),73例行急诊PCI治疗(PCI组)。比较3组血管再通率、左心室射血分数(LVEF)和病死率。结果:溶栓组梗死相关血管再通率为66.3%,PCI组为97.3%(P<0.01)。住院期间,对照组、溶栓组及PCI组间LVEF差异均有显著性(P<0.05)。3组患者住院期间病死率分别为9.4%、7.1%和4.1%,对照组与溶栓组、溶栓组与PCI组间比较差异不显著(P>0.05),但PCI组与对照组比较,P<0.05。溶栓再通和PCI成功患者住院期间LVEF和心肌缺血发生率(分别为16.9%和8.5%),差异均有显著性(P<0.05);住院期间病死率(1.5%和2.8%)无明显差异(P>0.05)。3组患者平均随访时间分别为(3.1±2.5)年、(3.6±2.4)年和(3.4±2.3)年,随访期间心梗再发率分别为23.1%、13.8%和7.4%,心肌缺血事件发生率分别为73.1%、55.2%和19.1%,需要再次行血运重建率分别为61.5%、42.5%和11.8%,LVEF值分别为0.456±0.121、0.568±0.132和0.615±0.115,病死率分别为15.4%、9.2%和5.9%,PCI组各项指标均优于对照组和溶栓组(P<0.05或P<0.01)。结论:老年AMI患者急诊PCI治疗的近期和远期预后优于溶栓治疗。
Objective：To evaluate the effect of two different revascularization treatments,i.e.percutaneous coronary artery intervention（PCI）and thrombolytic therapy,in elder patients with acute myocardial infarction（AMI）.Methods：Among 203patients（over 60 years old）with AMI,32 patients received conventional treatment including aspirin,low molecular heparin,etc.（control group）,and 98 patients received intravenous thrombolytic therapy（thrombolytic group）,and 73 patients received PCI and stent implantation treatment（PCI group）.The vessel reperfusion rate,left ventricular ejection fraction（LVEF）,and mortality were compared.Results：The vessel reperfusion rate of infarct related artery was 66.3%in thrombolytic group and 97.3%in the PCI group,the difference was significant（P〈0.01）.In the period of hospitalization,the difference in LVEF was significant among the three groups（P〈0.05）,and also in mortality rate between the PCI group（4.1%）and the control group（9.4%,P〈0.05）.Between the two groups of patients who were treated successfully by thrombolytic therapy or PCI therapy,the difference in LVEF was significant and also in the incidence of myocardial ischemia（16.9% vs.8.5%,both P〈0.05）,but no significant difference was found in mortality rate during hospitalization（1.5% vs.2.8%,P〈0.05）.For the control group,thrombolytic group and PCI group,the follow-up duration was（3.1±2.5）years,（3.6±2.4）years,and（3.4±2.3）years,respectively,and during the follow-up period,the recurrence rate of AMI was 23.1%,13.8% and 7.4%respectively,and the recurrence rate of myocardial ischemia was respectively 73.1%,55.2% and 19.1%,the incidence of revascularization were 61.5%,42.5% and 11.8%,LVEF were 0.456±0.121,0.568±0.132 and 0.615±0.115,the mortality rate was 15.4%,9.2% and 5.9%.The result was markedly better in PCI group compared to that of control group and thrombolytic group（P〈0.05 or P〈0.01）.Conclusions：Elderly patients with AMI undergoing PCI treatment show
出处
《感染．炎症．修复》
2015年第1期46-48,共3页
Infection Inflammation Repair
关键词
老年
心肌梗死
经皮冠状动脉
介入治疗
血栓溶解疗法
Eldly Myocardial infarction Percutaneous coronary artery intervention therapy Thrombolytic therapy
