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目的评价梗死相关血管为静脉桥血管(SVBG)的急性心肌梗死(AMI)患者,进行急诊直接经皮冠状动脉介入治疗(PCI)的有效性及安全性。方法对≥70岁(213例)与<70岁(96例)两组AMI患者介入治疗的临床效果和不良事件进行比较。分析SVBG有效再通比例、住院期间死亡比例及短期临床预后。结果两组患者PCI的技术成功比例、急性再闭塞比例均未见显著差异。但在≥70岁组,PCI后发生慢血流和无血流现象明显为多、住院期间绝对死亡数为多(20vs4)。死亡病例分析显示,90%的死亡病例出现在发生慢血流无血流现象的病例;多次心肌梗死、SVBG连通优势冠状动脉血管、以及连通惟一剩存的SVBG时,发生无血流慢血流后,死亡危险较高。结论老年AMI患者的SVBG病变急诊介入治疗有明确的效果和高的技术成功率。
Objective To evaluate the efficacy and safety of emergency percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) with infarction-related vascular graft (SVBG). Methods The clinical effects and adverse events of interventional therapy in AMI patients aged ≥70 years (213 cases) and <70 years (96 cases) were compared. Analysis of SVBG effective recanalization ratio, death rate during hospitalization and short-term clinical prognosis. Results There was no significant difference between the two groups in terms of technical success rate and acute reocclusion. However, at ≥70 years of age, there was a significant increase in both slow and no blood flow after PCI, and the absolute number of deaths during hospitalization was much (20 vs 4). Analysis of deaths showed that 90% of deaths occurred in cases of slow blood flow and no blood flow. Multiple myocardial infarctions, SVBG-linked coronary vessels, and the only residual SVBG were linked to a non-bleeding slow blood After the stream, the risk of death is higher. Conclusion The interventional treatment of SVBG in elderly AMI patients has definite effect and high technical success rate.