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目的探讨老年急性心肌梗死(AMI)并发糖尿病患者急诊经皮冠状动脉介入治疗(PCI)的安全性。方法将316例老年(≥60岁)AMI患者分为糖尿病组(DM组,76例)和非糖尿病组(ND组,240例),于发病12h内行急诊PCI,比较两组患者临床和冠状动脉造影特征、PCI成功率及术后并发症发生率。结果⑴DM组患者血脂异常、空腹血糖水平、前壁AMI百分比均显著高于ND组[分别为42.1%和24.2%,(10±3)mmol/L和(5±2.1)mmol/L,68.4%和49.6%,P<0.05]。⑵DM组患者的梗死相关血管为前降支者显著高于ND组(60.5%和42.1%,P<0.05),DM组三支病变、弥漫病变率显著高于ND组(78.9%和46.3%,67.1%和46.3%,P<0.01)。⑶PCI即刻成功率、术中无复流发生率、住院期间PCI术后并发症发生率和病死率两组比较差异均无统计学意义。结论急诊PCI治疗老年AMI并发糖尿病患者近期安全有效。
Objective To investigate the safety of emergency percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI) complicated with diabetes mellitus. Methods 316 elderly AMI patients (≥60 years old) were divided into DM group (DM group, 76 cases) and non-diabetic group (ND group, 240 cases). PCI was performed within 12 hours after onset. Clinical and coronary artery Radiographic features, PCI success rate and postoperative complication rate. Results (1) The levels of dyslipidemia, fasting blood glucose and anterior AMI in DM group were significantly higher than those in ND group [42.1% and 24.2%, (10 ± 3) mmol / L and (5 ± 2.1) mmol / L and 68.4% And 49.6%, P <0.05]. (2) The infarction-related blood vessels in the DM group were significantly higher than those in the ND group (60.5% and 42.1%, P <0.05), and the three lesions in the DM group were significantly higher than those in the ND group (78.9% and 46.3% 67.1% and 46.3%, P <0.01). ⑶PCI immediate success rate, intraoperative no-reflow incidence, postoperative PCI complications and mortality in the two groups were no significant difference between the two groups. Conclusions Emergency PCI is safe and effective in treating elderly patients with AMI complicated with diabetes.