CAJ | 학술논문

目的：评价不同年龄对急性心肌梗死经皮冠状动脉介入（PCI）治疗的安全性和临床疗效的影响。方法回顾性分析急性心肌梗死患者348例，按年龄分为3组，青中年组、年轻老年组及老年组，比较各组临床特征、冠状动脉病变特点及PCI成功率及手术并发症。结果老年组非ST段抬高型心肌梗死（NSTEMI）、行主动脉球囊反搏术（IABP）比例均高于青中年组（均P＜0.05）。青中年组患者病变多为单支病变，以前降支病变为主，病变类型中血栓型病变多见，单支病变例数及血栓例数与老年组比较差异均有统计学意义（均P＜0.05）；老年组患者的冠状动脉病变多为多支病变，与年轻老年组及青中年组比较差异均有统计学意义（均P＜0.05），病变类型中中重度钙化病变多见，与青中年组比较差异有统计学意义（P＜0.05）。PCI术中、术后并发症老年组高于青中年组及年轻老年组，PCI成功率老年组低于青中年组，死亡率高于青中年组及年轻老年组（均P＜0.05）。结论老年急性心肌梗死患者PCI成功率下降，并发症增加。
목적：평개불동년령대급성심기경사경피관상동맥개입（PCI）치료적안전성화림상료효적영향。방법회고성분석급성심기경사환자348례，안년령분위3조，청중년조、년경노년조급노년조，비교각조림상특정、관상동맥병변특점급PCI성공솔급수술병발증。결과노년조비ST단태고형심기경사（NSTEMI）、행주동맥구낭반박술（IABP）비례균고우청중년조（균P＜0.05）。청중년조환자병변다위단지병변，이전강지병변위주，병변류형중혈전형병변다견，단지병변례수급혈전례수여노년조비교차이균유통계학의의（균P＜0.05）；노년조환자적관상동맥병변다위다지병변，여년경노년조급청중년조비교차이균유통계학의의（균P＜0.05），병변류형중중중도개화병변다견，여청중년조비교차이유통계학의의（P＜0.05）。PCI술중、술후병발증노년조고우청중년조급년경노년조，PCI성공솔노년조저우청중년조，사망솔고우청중년조급년경노년조（균P＜0.05）。결론노년급성심기경사환자PCI성공솔하강，병발증증가。
Objective To evaluate the influence of age on safety and efficacy of percutaneous coronary intervention (PCI) of acute myocardial infarction (AMI). Methods 348 patients with AMI were retrospectively analyzed and divided into young and middle- aged group (YM group), younger elderly group and elderly group. The clinical characteristics, coronary lesions,PCI outcome were compared among the three groups. Results No ST- segment elevation myocardial infarction and the use of intra- aortic bal oon pump were significantly more in elderly group than in YM group (P<0.05). Single- vessel lesions, especial y anterior descending branch, and thrombosis were seen more in YM group, while moderately severe calcified lesions appeared more in elderly group. These were significantly different between the two groups (P<0.05). Multiple- vessel lesions trended to increase from YM group to elderly group. In elderly group, the complications and mortality of PCI were significantly higher compared with other groups, success rate was significantly lower compared with YM group (al P<0.05). Conclusion The success rate decreases and complications of PCI increase in elderly patients with AMI.