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目的评价老老年(≥80岁)急性心肌梗死(AMI)患者行急诊与择期经皮冠状动脉介入治疗术(PCI)的有效性和近期安全性。方法将120例老老年冠心病患者分为急性心肌梗死组(AMI组)和非心肌梗死组(对照组),其中AMI组发病12h内行直接PCI的患者为AMI急诊组,其他AMI患者(AMI择期组)和对照组患者均行择期PCI,两组合称为非急诊组,对各组的临床资料及冠脉介入特点进行回顾性分析。结果 AMI急诊组PCI即刻成功率(72.2%)低于非急诊组(92.2%),差异有统计学意义(P=0.036)。AMI急诊组并发症比非急诊组和AMI择期组高,差异有统计学意义(P<0.001,P=0.039),AMI组并发症及主要不良心脏事件发生率、院内死亡率均比对照组高(P<0.05)。结论在老老年AMI患者中,急诊与择期PCI手术成功率均较高,虽然急诊PCI术发生并发症的风险较高,但两者在院内死亡率和主要不良心脏事件发生率方面差异无统计学意义。
Objective To evaluate the effectiveness and short-term safety of emergency and elective percutaneous coronary intervention (PCI) in elderly patients (≥80 years) with acute myocardial infarction (AMI). Methods 120 elderly patients with coronary heart disease were divided into acute myocardial infarction (AMI) group and non-myocardial infarction group (control group). Patients in AMI group undergoing direct PCI within 12 hours after onset were AMI emergency group, AMI patients Group) and control group patients underwent elective PCI, the two groups were called non-emergency group, the clinical data of each group and the characteristics of coronary intervention were retrospectively analyzed. Results Immediate success rate (72.2%) of AMI emergency group was lower than that of non-emergency group (92.2%), the difference was statistically significant (P = 0.036). The complication of AMI emergency group was higher than that of non-emergency group and AMI elective group (P <0.001, P = 0.039). The incidence of complications and major adverse cardiac events and hospital mortality in AMI group were higher than those in control group (P <0.05). Conclusions The success rate of emergency and elective PCI in elderly patients with AMI is higher. Although there is a higher risk of complications in emergency PCI, there is no significant difference in the rates of in-hospital mortality and major adverse cardiac events significance.