急诊经皮冠状动脉介入治疗老年急性心肌梗死的疗效

目的观察急诊经皮冠状动脉介入治疗（PCI）对老年急性心肌梗死（AMI）患者的临床疗效及对恢复期左室重构的影响。方法将128例老年AMI患者随机分为2组，其中急诊PCI组66例，对照组62例，PCI组于发病12h内行急诊PCI术。对照组给于尿激酶150万单位静脉溶栓治疗。两组患者均给予抗凝、抗血小板药物及其他冠心病二级预防药物治疗。观察住院期间及1年内的心血管不良事件（MACE），并分别于发病后1、6个月做心脏彩超了解心功能及左室重构情况。结果与对照组相比，急诊PCI组住院期间及1年内MACE发生率明显降低（P〈0．01）；两组患者在发病1个月后左心室容积及射血分数差异无统计学意义，发病6个月后，PCI组左心室容积小于对照组（P〈0．05），射血分数高于对照组（P〈0．05），差异有统计学意义。结论急诊PCI可减少老年AMI患者MACE发生率，能阻止患者左室重构，改善其远期左室功能。

Impact of primary percutaneous coronary intervention on the efficacy and left ventricular remodeling in elderly acute myocardial infarction patients

Objective To observe the impact of primary percutaneous coronary intervention（PCI） on the efficacy and left ventricular（LV） remodeling in elderly acute myocardial infarction（AMI） patients. Methods 128 cases of elderly patients with AMI were randomly divided into two groups, 66 patients in PCI group and 62 in control group. The individuals in PCI group were performed PCI within 12 hours after onset of AMI. The individuals in the control group were injected into 1.5 million units Urokinase to dissolve thrombus. Two groups of patients took long - term anticoagulant, anti - platelet drugs and secondary prevention of coronary heart disease drugs. After one month and six months, the observation the major adverse cardiac events （MACE） at one year were studied and echocardiography examinations were performed to assess the channel in LV volumes, systolic function of all the individuals. Results In PCI group, the occurrence of MACE at one year were lower than those in control group （ P 〈 0.01 ）. The LV volumeand systolic function were no difference between the two groups after one month （ P 〈 0.05）. The LV volume was decreased （ P 〈 0. 05） and systolic function was improved （ P 〈 0.05） after six months. Conclusions Primary PCI of elderly patients with AMI can reduce the occasion of MACE and sinnificantly prevent the left ventricle reconstitution and improve the left ventricle prognosis in long- term.