老年急性心肌梗死并心源性休克32例临床分析

目的：分析老年急性心肌梗死（AMI)并心源性休克的危险因素及临床治疗效果。方法方便选取2013年1月—2016年1月期间该院收治的92例老年AMI患者为研究对象，根据患者并发心源性休克与否将患者分为并发组32例和未并发组60例，回顾性分析并发心源性休克的相关危险因素。同时，将32例老年AMI并发心源性休克患者分为观察组16例和对照组16例；对照组行常规药物治疗，观察组在常规治疗的基础上行经皮冠状动脉介入治疗，评价2组患者的临床治疗效果。结果既往有脑梗死、心肌梗死、合并慢性心功能不全、肾功能不全及室性心动过速均是老年AMI并发心源性休克的危险因素，且差异有统计学意义（P﹤0.05)。观察组患者临床治疗总有效率为81.25%，对照组为62.50%，2组比较，差异具有统计学意义（P﹤0.05)。结论老年AMI患者并发心源性休克的可能危险因素除心肌梗死相关面积、部位及病变支数外，包括既往有脑梗死史、心肌梗死史、合并慢性心功能不全、慢性肾功能不全及室性心动过速；临床治疗上行经皮冠状动脉介入治疗效果较内科保守治疗，可有效改善患者预后。

Clinical Analysis of 32 Cases of Acute Myocardial Infarction in Elderly Pa-tients with Cardiac Shock

Objective To analyze the risk factors and clinical effect of acute myocardial infarction (AMI) in elderly patients with cardiac shock. Methods During the period from January 2013 to January 2016, in 92 cases of elderly AMI patients as the research object, according to patients complicated with cardiogenic shock and whether the patients were randomly divid-ed into the concurrent group (32 cases) and without complication group (n= 60), the related risk factors of complicated with cardiogenic shock were retrospectively analyzed. At the same time, 32 cases of elderly patients with AMI complicated car-diac shock patients were divided into observation group (16 cases) and control group (16 cases);the control group underwent conventional drug treatment, the observation group in the conventional treatment based on the uplink percutaneous coronary artery interventional therapy, evaluation the clinical curative effect of the 2 groups of patients. Results The patients with cerebral infarction, myocardial infarction, chronic heart failure, renal dysfunction and ventricular tachycardia were risk fac-tors of elderly patients with AMI complicated with cardiogenic shock (P﹤ 0.05). Clinical observation of the patient group, the total effective rate was 81.25%, 62.50%in the control group, the 2 groups, the difference was statistically significant (P﹤0.05). Conclusion Elderly AMI patients complicated with cardiac shock of possible risk factors in addition to myocardial in-farction related area, location, including previous cerebral infarction history, history of myocardial infarction, combined with chronic heart function not failure, chronic kidney function not and ventricular tachycardia; clinical treatment of uplink per-cutaneous coronary artery interventional treatment effects than the medical conservative treatment, can effectively improve the prognosis of patients.