目的:探讨高龄急性心肌梗死(AMI)患者行急诊冠脉介入治疗(PCI)的可行性。方法:入选患者为2002-04-01/2007-06-30我院的住院患者共143例,均在12 h以内对梗死相关血管(IRA)急诊行经皮冠脉腔内成形术(PTCA)加冠脉内支架置入术,观察手术前后IRA的狭窄程度、TIMI血流、成功率和心功能情况。结果:143例患者靶病变平均狭窄程度为90%~100%,TIMI血流0~2级。急诊PTCA后共置入冠脉内支架176枚,140例经置入冠脉内支架后IRA均恢复到TIMI血流三级,残余狭窄为0%~10%。即刻成功率97.90%。住院期间总病死率1.40%。术后随访12~15个月,全部存活,心功能分级(NYHA)Ⅰ~Ⅲ级,无严重的心脏不良事件(死亡、再次心肌梗死、急诊冠脉旁路移植术)发生。结论:急诊冠脉介入治疗对高龄AMI成功率高,临床疗效显著,能明显降低心脏事件的发生和提高患者的生活质量。 Objective: To investigate the feasibility of emergency coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI). Methods: A total of 143 hospitalized patients in our hospital from 2002-04-01 / 2007-06-30 were enrolled in this study. All patients underwent coronary angioplasty (PTCA) for acute infarction - related artery (IRA) within 12 hours Intracranial stenting was performed to observe the degree of stenosis, TIMI flow, success rate, and cardiac function before and after surgery. Results: The average stenosis degree of target lesions was 90% ~ 100% in 143 patients, and the grade of TIMI was 0 ~ 2. A total of 176 intracoronary stents were placed after emergency PTCA. All 140 patients underwent intracoronary stenting, IRA returned to grade III TIMI with residual stenosis of 0% to 10%. Instant success rate of 97.90%. The total case fatality rate during hospitalization was 1.40%. All the patients were followed up for 12 to 15 months after operation. NYHA class I ~ III patients had no serious adverse cardiac events (death, recurrent myocardial infarction and emergency coronary artery bypass grafting). Conclusion: The success rate of acute coronary intervention in elderly patients with AMI is high, and the clinical curative effect is significant. It can significantly reduce the incidence of cardiac events and improve the quality of life of patients.