老年急性心肌梗死介入治疗的疗效及远期评价

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目的:评价老年急性ST段抬高型心肌梗死患者对接受急诊冠状动脉介入治疗(PCI)术对预后的影响。方法:将115例接受急诊PCI治疗的急性心肌梗死患者,根据年龄分为2组:青中年组30例、老年组85例。收集此115例患者的临床资料并对其出院后进行48个月的随访,以了解其主要不良心脏事件(MACE)的发生情况(15例)。结果:老年组危险因素比例(高血压、高血脂、糖尿病等)明显多于青中年组(P<0.05)。老年组单支病变、简单病变比例明显低于青中年组(P<0.05)。老年组多支病变、复杂病变比例高于青中年组(P<0.05)。老年组的LVEF明显低于青中年组(P<0.05)。随访期间,两组患者的MACE发生率明显增高,青中年组为9.52%、老年组为13.92%(P<0.05),无统计学意义(P>0.05)。结论:在接受急诊冠状动脉介入治疗的老年急性ST段抬高心肌梗死患者中,其主要不良心血管事件发生率随年龄增长而增高,当年龄和出院前的LVEF仍是预后影响的主要因素。 Objective: To evaluate the effect of emergency PCI on the prognosis of elderly patients with acute ST-segment elevation myocardial infarction. Methods: A total of 115 patients with acute myocardial infarction who underwent emergency PCI were divided into two groups according to their ages: 30 in the middle-aged group and 85 in the elderly group. The clinical data of 115 patients were collected and followed up for 48 months after discharge from the hospital to understand the incidence of major adverse cardiac events (MACEs) (n = 15). Results: The proportion of risk factors in the elderly group (hypertension, hyperlipidemia, diabetes, etc.) was significantly higher than that of the middle-aged and young adults (P <0.05). Single-vessel disease in the elderly group, the proportion of simple lesions was significantly lower than the young middle-aged group (P <0.05). The multi-vessel disease and complex lesions in the elderly group were higher than those in the middle-aged and young group (P <0.05). The LVEF in the elderly group was significantly lower than that in the young middle-aged group (P <0.05). During the follow-up period, the incidence of MACE in both groups was significantly increased, 9.52% in young middle-aged patients and 13.92% in elderly patients (P <0.05), with no significant difference (P> 0.05). CONCLUSIONS: The incidence of major adverse cardiovascular events in elderly patients with acute ST-elevation myocardial infarction receiving emergency coronary intervention increases with age, with age and LVEF prior to discharge still being the major prognostic factors.
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