老年ST段抬高型与非ST段抬高型急性心肌梗死患者支架术临床评价

目的　评价老年ST段抬高型与非ST段抬高型AMI患者支架治疗的临床疗效及安全性。方法　分析 2 0 0 0 - 0 1～ 2 0 0 3- 0 6间在我院行PTCA及支架术的老年ST段抬高型与非ST段抬高型AMI患者 6 7例 ,(其中老年ST段抬高型急性心肌梗死患者 5 1例 ,非ST段抬高型AMI患者 16例 ,)观察术后即刻及远期疗效。结果　冠脉造影显示单支病变 38例 ,双支病变 2 4例 ,3支病变 5例 ,其中 2例为糖尿病合并 3支病变 ,行搭桥手术 ,其余患者均实行支架置入术 ,术后梗死相关血管血流均达到TIMI 2～ 3级。夹层 1例 ,支架置入后夹层消失 ,其中 2例因髂动脉严重迂曲 ,导管无法通过而改经桡动脉经路 ,1例术中行冠脉内溶栓血管再通后置入支架。结论　老年AMI介入治疗疗效可靠、安全可行

Clinical Assessment of PTCA and Stent Implantation Treatment for Elderly Patients with STEMI and NSTEMI

Objective To evaluate the clinical effect and the safety of the interventional treatment. Methods The data of 67 elderly cases with STEMI and NSTEMI were analyzed who were underwent PTCA and stent implantation treatment from January, 2001 to June 2003 in our hospital. Among them, there were 51 STEMI cases and 16 STEMI cases. The clinical effect of long term follow-up were observed. Results Through coronary angiography, the patients with pathological changes were 38 cases for 1 branch, 24 cases for 2 branches and 5 cases for 3 branches. Among them, there were 2 diabetes cases had three pathological branches. 2 patients had the by-pass treatment. The others had the PTCA and stent implantation. After the treatment, the blood stream of the crime vessels all reached TIMI 2～3 level. 1 case had the lamina which was vanished after the treatment. There were 2 cases through radial artery because the iliac arteries were severe circuity. There was 1 case underwent throbolysis then PTCA and stent implantation. Conclusion The interventional treatment were credible and secure for the elderly patient with AMI.