摘要
目的探讨经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)对高龄急性心梗患者的安全性及有效性。方法方便选择2015年1月—2017年12月在宜兴市人民医院心内科住院的急性心肌梗死的年龄≥75岁的老年患者100例,收集基线资料,检测cTNT、hs-CRP、血脂、生化等,所有患者均行床边心超检查,随访1年,观察1年内主要不良心血管事件(major adverse cardiovascular events,MACE);纳入患者分为两组,对照组给予冠心病规范药物保守治疗(50例),手术组给予PCI治疗+药物规范化治疗(50例)。结果手术组在临床症状、左室射血分数较对照组明显改善,差异有统计学意义(28%vs 10%)(χ^2=4.336,P<0.05);(43.31±6.46)%vs(48.85±3.80)%(t=-3.359,P<0.05),而两组在NT-proBNP比较差异无统计学意义(3 055.44±407.11)pg/mL vs(2 917.48±289.21)pg/mL(t=0.276,P>0.05);在死亡率、出现并发症以及随访1年内的MACE事件比较中,手术组均少于对照组,差异有统计学意义(14%vs 2%),(χ^2=4.759,P<0.05);(42%vs 18%)(χ^2=6.857,P<0.05);(30.2%vs 14.3%)(χ^2=5.341,P<0.05);两组在不同心梗类型在院死亡率比较发现,前壁心梗中手术组死亡率明显低于对照组(10%vs 0%)(χ^2=5.263,P<0.05),而下壁心梗及非ST段抬高心梗死亡率在两组之间差异无统计学意义(2%vs 0%)(χ^2=0.315,P>0.05);(2%vs 2%)(χ^2=1.00,P>0.05)。结论PCI术治疗能明显减少高龄急性心梗患者住院期间及出院1年内的MACE,而对于前壁心梗患者手术治疗能明显降低死亡率,改善预后,并且安全有效。
Objective To investigate the safety and efficacy of percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction. Methods One hundred elderly patients aged 75 years or older with acute myocardial infarction admitted to the Department of Cardiology, Yixing People's Hospital from January 2015 to December 2017 were convenient selected and enrolled. Baseline data were collected to detect cTNT, hs-CRP, blood lipids, biochemistry, etc. All patients underwent bedside echocardiography, followed up for 1 year, and observed major adverse cardiovascular events (MACE) within 1 year. Patients were divided into two groups, and the control group received conservative treatment for coronary heart disease (50 cases);the surgical group received PCI treatment + standardized treatment of drugs (50 cases). Results 1.The clinical symptoms and left ventricular ejection fraction of the operation group were significantly improved compared with the control group, with statistical statistically significant (28% vs 10%) (χ^2=4.336, P<0.05);(43.31±6.46) vs (48.85±3.80) (t=-3.359, P<0.05), and there was no significant difference between the two groups in NT-proBNP (3 055.44±407.11) vs (2 917.48±289.21) (t=0.276, P>0.05);in the mortality, complications, and comparison of MACE events within 1 year of follow-up, the surgery group All were less than the control group, which was statistically significant (14% vs 2%) (χ^2=4.759, P<0.05);42% vs 18%) (χ^2=6.857, P<0.05);(30.2% vs 14.3%) (χ^2=5.341, P<0.05);The mortality of the two groups in different types of myocardial infarc tion showed that the mortality of the anterior wall myocardial infarction was significantly lower than that of the control group (10% vs 0%)(χ^2=5.263, P<0.05), while the inferior myocardial infarction and non-ST mortality had no statistically significant difference between the two groups (2% vs 0%)(0.315, P>0.05);(2% vs 2%)(χ^2=1.00, P>0.05). Conclusion PCI can significantly reduce the MACE of elderly patients with acute myocardial infarction during hospitalization and discharge within 1 year, and the surgical treatment of anterior wall myocardial infarction can significantly reduce mortality, improve prognosis, and is safe and effective.
作者
任月如
殷云杰
季燕妮
赵祥海
徐亮
陈燕春
REN Yue-ru;YIN Yun-jie;JI Yan-ni;ZHAO Xiang-hai;XU Liang;CHEN Yan-chun(Department of Cardiology,Yixing People's Hospital,Yixing,Jiangsu Province,214200 China)
出处
《中外医疗》
2019年第18期20-22,53,共4页
China & Foreign Medical Treatment
关键词
经皮冠状动脉介入治疗
急性心肌梗死
主要不良心血管事件
Percutaneous coronary intervention
Acute myocardial infarction
Major adverse cardiovascular events
