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目的分析高龄ST段抬高型急性心肌梗死(STEMI)患者临床特征及评价直接冠状动脉介入治疗(直接PCI)的疗效。方法选择直接行PCI治疗STEMI患者121例,75岁以上47例为高龄组,同期60～74岁74例为对照组。观察两组患者临床特征、直接PCI术成功率、心电图ST段回落、心绞痛改善、住院期间主要不良心脏事件(MACE)发生率。结果高龄组、对照组直接PCI术后即刻成功率分别为97.87%、97.30%,术后2 h心电图ST段回落≥50%分别为78.72%、72.92%,术后心绞痛明显改善率分别为88.11%、86.49%,住院期间MACE发生率分别为2.12%、2.70%;两组以上观察指标比较差异无统计学意义。结论STEMA急性闭塞病变行直接PCI治疗时植入支架近期临床疗效显著,且成功率及安全性均较高。
Objective To analyze the clinical features of elderly patients with STEMI and evaluate the effect of direct coronary intervention (PCI). Methods 121 patients with STEMI were directly treated with PCI, 47 patients aged 75 years and above were in the advanced age group and 74 patients aged 60-74 in the same period as the control group. The clinical characteristics, success rate of direct PCI, ST-segment depression of ECG, improvement of angina and incidence of major adverse cardiac events (MACE) during hospitalization were observed. Results The successful rate of immediate PCI immediately after PCI was 97.87% and 97.30% in the elderly group and the control group respectively. The ST-segment drop ≥50% at 2 h after operation was 78.72% and 72.92% respectively. The improvement rates of postoperative angina pectoris were 88.11% , 86.49% respectively. The incidence of MACE during hospitalization was 2.12% and 2.70% respectively. There was no significant difference between the two groups in the above indexes. Conclusion The immediate clinical effect of stent implantation in STEMA acute obstructive lesions treated with direct PCI is significant and the success rate and safety are high.