老年人急性心肌梗死后冠状动脉自发再灌注的影响因素研究

目的探讨老年人急性心肌梗死(AMI)后冠状动脉自发再灌注(SR)的影响因素。方法 77例首次发作AMI且未经静脉溶栓及其它再灌注治疗的老年患者,根据选择性冠状动脉造影(CAG)检查结果分成自发再灌注组(TIMI≥2级)与无自发再灌注组(TIMI 0～1级),采用Logistic回归分析寻找对SR影响有意义的因素。结果①急性心肌梗死后冠状动脉自发再灌注率为41.6%。②梗死前心绞痛(OR=7.077,95%CI:1.810,27.669)、起病至开始治疗时间的长短(OR=0.124,95%CI:0.048,0.326)与SR的发生有关。结论未经静脉溶栓及其它再灌注治疗的老年AMI患者存在一定的自发再灌注率,梗死前心绞痛的发生,使SR的发生可能性增大;起病至开始治疗时间延长,使SR发生可能性减小。

Study on Influencing Factors of Spontaneous Coronary Recanalization in Elderly Patients with Acute Myocardial Infarction

Objective To explore the determinants of spontaneous coronary recanalization（SR） in senile patients with acute myocardial infarction（AMI）.Methods According to the results of selective coronary angiography,77 senile patients with first-episode AMI who did not receive intravenous thrombolytic therapy and other reperfusion treatments were divided into SR group（TIMI≥2 grade） and non-SR group（TIMI 0-1 grade）.Logistic regression analysis was used to analyze the determinants of SR.Results The probability of SR in acute myocardial infarction was 41.6%.Preinfarction angina（OR=7.077,95%CI： 1.810,27.669） and the interval from symptom to medical therapy（OR=0.124,95%CI：0.048,0.326） were related to the occurrence of SR.Conclusions SR has a certain probability in senile patients with acute myocardial infarction（AMI） without intravenous thrombolytic therapy and other reperfusion treatments.The occurrence of preinfarction angina can increase the probability of SR,while the prolonged interval from symptom to medical therapy is likely to reduce the chance of SR.