CAJ | 학술논문

目的观察直接经皮冠状动脉内介入治疗(PCI)对老年急性ST段抬高性心肌梗死(STEMI)患者疗效及安全性. 方法入选连续行直接PCI治疗的STEMI患者103例,根据年龄分为老年组49例组和非老年组54例,收集临床资料,观察手术并发症、成功率,随访1～6个月患者主要心血管事件(MACE)的发生率. 结果老年组中女性、Killip≥Ⅲ级、3支病变比例、血浆脑钠肽浓度高于非老年组(P＜0.05).PCI成功率、并发症差异无统计学意义(P＞0.05).随访平均(5.7±1.2)个月,住院期间老年组死亡率8.16％(4例),非老年组无死亡病例,两组比较差异有统计学意义(P＜0.05),半年死亡率、两组各时间点MACE比较差异无统计学意义(P＞0.05).多变量Logistic回归分析提示STEMI患者行直接PCI后1个月死亡增加与Killip≥Ⅲ级相关,而与年龄无关. 结论直接PCI治疗老年STEMI患者安全、有效.
목적 관찰직접경피관상동맥내개입치료(PCI)대노년급성ST단태고성심기경사(STEMI)환자료효급안전성. 방법 입선련속행직접PCI치료적STEMI환자103례,근거년령분위노년조49례조화비노년조54례,수집림상자료,관찰수술병발증、성공솔,수방1～6개월환자주요심혈관사건(MACE)적발생솔. 결과 노년조중녀성、Killip≥Ⅲ급、3지병변비례、혈장뇌납태농도고우비노년조(P＜0.05).PCI성공솔、병발증차이무통계학의의(P＞0.05).수방평균(5.7±1.2)개월,주원기간노년조사망솔8.16％(4례),비노년조무사망병례,량조비교차이유통계학의의(P＜0.05),반년사망솔、량조각시간점MACE비교차이무통계학의의(P＞0.05).다변량Logistic회귀분석제시STEMI환자행직접PCI후1개월사망증가여Killip≥Ⅲ급상관,이여년령무관. 결론 직접PCI치료노년STEMI환자안전、유효.
Objective To investigate the effect and safety of primary percutaneous coronary intervention (PCI) of acute ST-segment elevation myocardial infarction (STEMI) in elderly patients.Methods 103 consecutive patients with STEMI treated by primary PCI were divided into two groups according to the age:the elderly group [aged≥65 years,with a mean age of (75.7 ±6.2) years(n =49],the non-elderly group [aged＜65 years,with a mean age of (43.0±8.6) years(n =54].Clinical characteristics,complications related to PCI procedure and success rate were analyzed,and major cardiovascular events (MACE) were followed up for(5.7 ± 1.2) months.Results The proportion of female,patients with Killip ≥ Ⅲ,three vessels disease and higher level of serum brain natriuretic peptide were higher in elderly group than in non-elderly group (all P＜0.05).No significant difference was observed between the two groups in success rate and complications of PCI procedure (both P＞0.05).Patients were followed up for (5.7± 1.2) months.The in-hospital and one-month mortalities were higher in elderly group than in non-elderly group [8.2％ (4 cases)vs.0％ (0 case),10.2％(5 cases) vs.0 ％ (0 case),respectively,all P＜0.05].There was no significant difference in six-month mortality and MACE between the two groups.Multivariate logistic regression analysis showed that Killip ≥ Ⅲ was related with the increase of one-month mortality in patients with STEMI undergoing primary PCI,whereas age was not.Conclusions Primary PCI is effective and safe in elderly patients with STEMI.