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目的探讨不同治疗方法对老年急性心肌梗死的疗效和安全性。方法选择老年ST段抬高急性心肌梗死患者483例,根据不同治疗方法分为常规治疗组(A组,73例)、溶栓治疗组(B组,182例)和急诊PCI组(C组,228例)。回顾性对比分析患者的血管再通率、住院时间和不良心血管事件的发生率。结果与A组比较,B组和C组患者平均住院时间明显缩短(P<0.05),血管再通率明显升高(P<0.05);而C组血管再通率明显高于B组(P<0.05);与A组和B组比较,C组患者心肌梗死后心绞痛、再梗死、严重心律失常、中度以上心力衰竭,心源性休克以及随访第30天病死率均明显降低,差异有统计学意义(P<0.05)。B组皮肤黏膜出血和严重颅内出血明显高于A组和C组患者,差异有统计学意义(P<0.05)。结论老年急性心肌梗死行急诊PCI优于溶栓治疗和常规治疗。
Objective To investigate the efficacy and safety of different treatment methods for elderly patients with acute myocardial infarction. Methods A total of 483 elderly patients with acute ST-segment elevation myocardial infarction (AMI) were enrolled in this study. The patients were divided into two groups: conventional treatment group (A group, 73 cases), thrombolysis group (B group, 182 cases) and emergency PCI group 228 cases). Retrospective analysis of patients with recanalization rate, length of hospital stay and incidence of adverse cardiovascular events. Results Compared with group A, the average length of hospital stay in group B and group C was significantly shorter (P <0.05) and the rate of recanalization was significantly higher (P <0.05), while the rate of recanalization in group C was significantly higher than that in group B <0.05). Compared with group A and group B, the post-MI myocardial infarction angina pectoris, reinfarction, severe arrhythmia, moderate to severe heart failure, cardiogenic shock and the mortality at the 30th day of follow-up in group C were significantly decreased Statistical significance (P <0.05). The skin mucosal hemorrhage and severe intracranial hemorrhage in group B were significantly higher than those in group A and group C, with significant difference (P <0.05). Conclusion Elderly patients with acute myocardial infarction in emergency PCI better than thrombolytic therapy and routine treatment.