急诊经皮冠状动脉介入治疗AMI的死亡率与侧支循环形成的关系

目的分析急性心肌梗死(AMI)患者行急诊经皮冠状动脉介入(PCI)治疗手术中及住院期间死亡率与患者侧支循环形成的关系。方法1999年3月～2006年10月于我科行急诊PCI治疗的AMI患者623例。发病至介入治疗时间为2～36h。结果患者死亡27例,死亡率为4.3%。60岁以下死亡率1.7%(4/232),60～75岁死亡率为5.0%(14/279),75岁以上患者的死亡率为8.0%(9/112)。侧支循环形成率60岁以下为91.4%(212/232),60～75岁61.6%(172/279),75岁以上37.5%(42/112)。结论PCI治疗AMI的死亡率与侧支循环形成率呈负相关。年轻患者侧支循环形成率较高,相应死亡率也较低。老年患者死亡率较高,可能与侧支循环形成率较低有关。

Correlation between coronary collateral circulation and mortality after percutaneous coronary intervention in patients with acute myocardial infarction

Objective:To study the correlation between coronary collateral circulation and mortality after percutaneous coronary intervention(PCI)in patients with AMI during the operation and hospital stay.Methods:From Mar.1999 to Jun.2006,emergency PCI were performed in 623 patients with AMI who were 26-91 years old.Among them 232 were younger than 60,279 were between 60-75 years old,and 112 were older than 75.The time from the onset of the disease to intervention is 2-36 hours.Results:Twenty seven of the patients died, the total mortality was 4.3%.Four of the patients who were younger than 60 died,the mortality was 1.7%(4/232);fourteen of the patients who were between 60-75 years old died,the mortality was 5.0%(14/279);nine of the patients who were older than 75 died,the mortality was 8.0%(9/112).The oronary collateral circulation formation rate in patients younger than 60,between 60-75 years old and older than 75 were 91.4%(212/232),61.6%(172/279)and 37.5%(42/112)respectivly.Conclusion There is negative correlation between the formation rate of coronary collateral circulation and mortality in patients with AMI who received emergency PCI. The formation rate of coronary collateral circulation is higher in young people ,and the mortality of them is lower. The mortality of the old people is high.This maybe more or less due to their low formation rate of coronary collateral circulation.