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目的评价老龄急性ST段抬高性心肌梗死(STEMI)患者急诊经皮冠状动脉介入(PCI)治疗的临床疗效。方法分析66例老龄急性STEMI患者临床资料,分为急诊PCI治疗组和药物保守治疗组,比较两组住院时间及住院期间心血管事件(不稳定型心绞痛、心功能不全、心律失常、再次心肌梗死、急诊冠状动脉旁路移植术及死亡)的发生情况。结果急诊PCI治疗组血管造影成功率为100%,介入治疗成功率为98%。急诊PCI治疗组与药物保守治疗组相比,住院时间分别为(7.75±1.80)d和(10.53±3.45)d(P<0.05);住院期间不稳定型心绞痛发生率分别为12.5%和34.6%(P<0.05);心功能不全发生率分别为22.5%和57.7%(P<0.05);心律失常发生率分别为17.5%和38.5%(P<0.05);病死率分别为5.1%和23.1%(P<0.05)。两组再次心肌梗死发生率及行急诊冠状动脉旁路移植术的比例差异无统计学意义。结论对于老龄急性STEMI患者行急诊PCI治疗是安全有效的,可以减少住院期间心血管事件的发生。
Objective To evaluate the clinical efficacy of emergency percutaneous coronary intervention (PCI) in elderly patients with acute ST-segment elevation myocardial infarction (STEMI). Methods The clinical data of 66 elderly patients with acute STEMI were divided into two groups: the emergency PCI group and the conservative drug group. The duration of hospitalization and cardiovascular events (unstable angina pectoris, cardiac insufficiency, arrhythmia, myocardial infarction , Emergency coronary artery bypass grafting and death) of the occurrence. Results The success rate of angiography in emergency PCI group was 100% and the success rate of interventional therapy was 98%. The hospitalization time of emergency PCI group was (7.75 ± 1.80) d and (10.53 ± 3.45) days respectively (p <0.05), while the incidence of unstable angina pectoris during hospitalization was 12.5% and 34.6% respectively (P <0.05). The incidence of cardiac dysfunction was 22.5% and 57.7% respectively (P <0.05). The incidence of arrhythmia was 17.5% and 38.5% respectively (P <0.05) (P <0.05). There was no significant difference in the incidence of recurrent myocardial infarction and emergency coronary artery bypass grafting in both groups. Conclusion It is safe and effective to treat emergency STEMI in elderly patients with acute STEMI and reduce the occurrence of cardiovascular events during hospitalization.