CAJ | 학술논문

目的：探讨PCI对老年女性急性心肌梗死（AMI）合并糖尿病的近期疗效和安全性。方法选择接受急诊PCI的老年AMI合并糖尿病患者135例，分为女性组46例，男性组89例，比较2组临床资料、GRACE评分、冠状动脉病变特征、住院时间和并发症发生率。结果与男性组比较，女性组高脂血症显著升高（80．43％ v s 62．92％， P＝0．037），心肌梗死前心绞痛偏低（4．35％ vs 20．22％，P＝0．027）；GRACE积分高危比例显著升高（45．65％ vs 25．84％，P＝0．019）；术后T IM I 3级血流和心肌灌注3级显著偏低（ P＜0．01）；置入支架的直径显著偏细、长度显著偏长[（2．8±2．3）mm vs （3．1±0．4）mm ，（28．5±3．7）mm vs （21．4±4．3）mm ，P＜0．05]。女性组平均住院时间、梗死后心绞痛、住院期间再梗死、严重心律失常、K illip＞Ⅲ级心功能和30 d病死率显著高于男性（ P＜0.05， P＜0．01）。结论老年女性AMI合并糖尿病患者PCI术后TIMI血流和心肌灌注低，并发症多于男性。
목적：탐토PCI대노년녀성급성심기경사（AMI）합병당뇨병적근기료효화안전성。방법선택접수급진PCI적노년AMI합병당뇨병환자135례，분위녀성조46례，남성조89례，비교2조림상자료、GRACE평분、관상동맥병변특정、주원시간화병발증발생솔。결과여남성조비교，녀성조고지혈증현저승고（80．43％ v s 62．92％， P＝0．037），심기경사전심교통편저（4．35％ vs 20．22％，P＝0．027）；GRACE적분고위비례현저승고（45．65％ vs 25．84％，P＝0．019）；술후T IM I 3급혈류화심기관주3급현저편저（ P＜0．01）；치입지가적직경현저편세、장도현저편장[（2．8±2．3）mm vs （3．1±0．4）mm ，（28．5±3．7）mm vs （21．4±4．3）mm ，P＜0．05]。녀성조평균주원시간、경사후심교통、주원기간재경사、엄중심률실상、K illip＞Ⅲ급심공능화30 d병사솔현저고우남성（ P＜0.05， P＜0．01）。결론노년녀성AMI합병당뇨병환자PCI술후TIMI혈류화심기관주저，병발증다우남성。
Objective To study the short‐term efficacy and safety of emergency PCI in elderly fe‐male acute myocardial infarction (AMI) patients with diabetes mellitus (DM ) .Methods One hundred and thirty‐five elderly AMI patients with DM who underwent emergency PCI were divid‐ed into female group (n= 46) and male group (n= 89) .Their clinical data ,risk score of global acute coronary vents registry ,characteristics of coronary artery lesion ,hospital stay time (day ) and incidence of complications were compared .Results The incidence of hyperlipidemia was sig‐nificantly higher in female group than in male group (80 .43% vs 62 .92% ,P=0 .037) .The histo‐ry of smoking and PCI was shorter and the incidence of angina pectoris before myocardial infarc‐tion was significantly lower in female group than in male group (P< 0 .05 ,P< 0 .01) .The risk score of global acute coronary vents registry was significantly higher in female group than in male group (45 .65% vs 25 .84% ,P<0 .05) .The postoperative TIMI3 flow and TIMI TMPG3 were significantly lower in female group than in male group (P<0 .001) .The diameter of implanted stents was significantly shorter and the implanted stents were significantly longer in female group thaninmalegroup(2.8±2.3mm vs3.1±0.4mm,28.5±3.7mm vs21.4±4.3mm,P<0.05). The average hospital stay time was significantly shorter ,the incidence of angina pectoris following myocardial infarction ,reinfarction during hospital stay ,the Killip Ⅲ‐Ⅳ and 30‐day mortality were significantly lower in female group than in male group (P< 0 .05 ,P< 0 .01) .Conclusion The TIMI3 flow and TMPG3 are low in elderly female AMI patients with DM after PCI with a high incidence of complications in male patients .