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目的分析老年急性心肌梗死(AM I)患者行直接冠状动脉介入治疗(PC I)的可行性及近远期疗效。方法196例AM I患者分为老年组(108例)和非老年组(88例),分析两组患者临床特征、冠脉病变特点、是否进行球囊预扩张、支架植入情况、近远期疗效。结果老年组患者多有冠心病史(44.4%vs 23.9%,P=0.003);老年组梗死相关动脉(IRA)以LAD(50.9%)和RCA(44.4%)为主,非老年组IRA以LAD(59.1%)为主(P=0.005);两组IRA狭窄程度、病变形态无差异性(P均>0.05);老年组常有2支或3支冠脉病变(80.6%),非老年组患者以单支病变为主(46.6%,P=0.001);与非老年组相比,老年组支架植入前常需进行球囊预扩张(89.2%vs 72.3%,P=0.004),但植入支架直径、长度及血运重建程度无差异性。住院及随访期间老年组靶血管血运重建率及死亡率均较非老年组偏高,但未达到统计学意义。结论老年AM I患者进行直接PC I安全有效,但与非老年患者相比,支架植入前常需进行球囊预扩张。
Objective To analyze the feasibility and short-term efficacy of direct coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI). Methods One hundred and sixty-six patients with AMI were divided into the elderly group (n = 108) and the non-elderly group (n = 88). The clinical characteristics, coronary artery lesion characteristics, pre-dilatation of balloon, stent implantation, Efficacy. Results The elderly patients had a history of coronary heart disease (44.4% vs 23.9%, P = 0.003). The incidence of infarction-related artery (IRA) in the elderly group was mainly LAD (50.9%) and RCA (59.1%) (P = 0.005). There was no difference between the two groups in the degree of stenosis and the pathological changes (all P> 0.05). The elderly patients had two or three coronary lesions (80.6% Patients were predominantly single-vessel disease (46.6%, P = 0.001). Compared with the non-elderly group, pre-balloon balloon dilatation (89.2% vs 72.3%, P = 0.004) Into the stent diameter, length and extent of revascularization no difference. During hospitalization and follow-up, the target vessel revascularization rate and mortality in the elderly group were higher than those in the non-elderly group, but did not reach statistical significance. Conclusions Elderly patients with AMI are safe and effective in direct PCI, but pre-dilatation of the balloon is often required prior to stent implantation compared with non-elderly patients.