70岁以上老年急性心梗患者临床特征和急诊PCI术后预后观察

目的：分析70岁以上老年急性心肌梗死（AMI）患者的临床特征，并观察急诊经皮冠状动脉介入治疗（PCI）的近期疗效。方法：采用回顾性分析的方法，100例行急诊PCI术的AMI患者被分为≥70岁组（30例）和〈70岁组（70例），比较两组危险因素、冠脉造影、并发症等特点。结果：与〈70岁组比较，≥70岁组女性、糖尿病、高血压及冠脉多支病变比例均显著升高，吸烟、冠脉单支病变比例明显较低，PCI治疗时间[（49．0±19．4）min比（61．0±22．5）min]显著增加（P〈0.05或P〈0．01）；住院期间发生KillipⅢ级以上心力衰竭（11．43％比40．00％）、严重心律失常（28．57％比53．33％）、心源性死亡（1．43％比10．00％）及出血并发症（1．43％比10．00％）比例显著升高（P〈0．05或〈0.01）；PCI成功率，术后6个月两组因心肌梗死或心力衰竭住院率及死亡率无明显差异（P均〉0.05）。结论：70岁以上老年患者发生急性心肌梗死，其临床特征和〈70岁患者有别，其近期预后更差，术后6个月的预后与〈70岁患者比较无显著差异。

Clinical features of aged patients over 70 years old with acute myocardial infarction and their short - term prognosis after emergency PCI

Objective： To analyze the clinical features of aged patients over 70 years old with acute myocardial lntarction （AMI） and observe the short - term therapeutic effect after emergency percutaneous coronary intervention （PCI）, Methods： Retrospective analysis method was used. A total of 100 AMI patients undergoing emergency PCI were divided into ≥70 years old group （n = 30） and （70 years old group （n = 70）. Risk factors, coronary angiography （CAG） and complications were compared between two groups. Results： Compared with （70 years old group, there were significant increase in percentages of female, diabetes mellitus, hypertension, multi - vessel coronary dis- ease and PCI time [ （49.0 ±19.4） rain vs. （61.0 ±22.5） mini, and significant decrease in percentages of smokers and single-vessel coronary disease in ≥70 years old group, P〈0.05 or d0.01; during admission, there were significant increase in percentages of patients occurring heart failure over Killip class Ⅲ （11.43% vs. 40.00%）, severe arrhythmia （28.57% vs. 53.33%）, cardiogenic death （1.43% vs. 10.00%） and hemorrhage （1.43% vs. 10.00%） in ≥70 years old group, P〈0.05 or 〈0.01; There was no significant difference in successful rate of PCI between two groups, P〈0.05. After six-month follow up, there were no significant difference in rehospitalization rate caused by myocardiai infarction or heart failure and mortality between two group, P〈0.05 both. Conclusion： The clinical features of aged patients over 70 years old with acute myocardial infarction are different from those of 〈70 years old patients, their short-term prognosis is worse, but prognosis after PCI 6 month is no significant difference compare with 〈70 years old patients.