老年急性心肌梗死患者急诊介入治疗围术期死亡的临床特点分析

目的:探讨老年急性心肌梗死(AMI)患者行急诊经皮冠状动脉(冠脉)介入(PCI)治疗围术期死亡的临床特点。方法:回顾性分析2003年至2013年我院行急诊PCI的中年(50~69岁)和老年(≥70岁)AMI患者755例,记录围术期死亡患者的临床资料、冠脉病变特点及死亡原因。结果:老年AMI患者急诊PCI围术期病死率显著高于中年AMI患者(P0.05)。与死亡的中年AMI患者相比,老年AMI患者糖尿病患病率显著增加(P0.05)。死亡的老年AMI患者冠脉病变主要累及多支血管、Gensini积分明显高于中年AMI患者(P0.05)。老年和中年AMI患者最常见的死亡原因均是心源性休克(P0.05)。结论:老年AMI患者急诊PCI围术期病死率高,死亡的老年患者合并糖尿病患病率高,冠脉病变主要累及多支血管、狭窄程度严重,最常见的死亡原因是心源性休克。

Analysis of clinical characteristics of elderly acute myocardial infarction patients died perioperatively for emergency percutaneous coronary intervention

Objective To analyze the clinical characteristics of elderly acute myocardial infarction （AMI） patients died perioperatively for emergency percutaneous coronary intervention （PCI）. Methods A total of 755 middle-aged and elderly AMI patients treated in Changhai Hospital during 2003 to 2013 were retrospectively analyzed. The clinical data, angiographic findings and causes of death were analyzed. Results Perioperative death rate in elderly patients undergoing emergency PCI for AMI was significantly higher than that in middle-aged patients （P〈0.05）. The incidence of diabetes was significantly higher in elderly patients than in middle-aged patients （P〈0.05）. The elderly patients were more likely to have multi-vessel lesions and a higher Gensini score by angiography （P〈0.05）. The leading cause of perioperative death in the middle-aged and elderly patients was cardiogenic shock （P 〉0.05）. Conclusions Elderly AMI patients undergoing emergency PCI had a higher perioperative death rate with a higher incidence of diabetes. The elderly patients had lesions involving multiple vessels and a higher Gensini score. The leading cause of perioperative death was cardiogenic shock.