摘要：目的：观察和评价急诊冠状动脉介入治疗(PCI)治疗老年急性心肌梗死(AMI)的疗效和安全性。方法：回顾性分析2004年7月至2006年7月因急性心肌梗死实行急诊PCI(≤12h)的患者61例，其中≥60岁的30例(老年组)，<60岁的31例(中轻组)，分析两组基础资料特征，即刻手术成功率和随访期间主要不良心血管事件(复发性心绞痛、心肌梗死及猝死)发生率的差异。结果：老年组心力衰竭及多支病变比例高于中轻组(分别为40%，6%和52%，23%，P均<0.05)，老年组入院至梗死相关动脉开通时间长于中轻组[(63.86±16.7)min (51.16±13.5)min，P<0.05]。两组患者急诊PCI成功率分别为老年组97%，中轻组100%,两组无显著差异(P>0.05)。住院期间死亡老年组3例，中轻组0例,两组亦无显著差异(P>0.05)。随访4个月至2年，老年组发生心绞痛6例、心肌梗死3例、猝死0例(共占30%)；中轻组发生心绞痛2例、心肌梗死1例、猝死0例(总计10%)，随访期间主要不良心血管事件发生率两组有显著性差异(P<0.05)。结论：急诊PCI成功率和住院期间死亡率老年组和中轻组无显著差异，虽然老年组心血管不良事件发生率高于中轻组，但仍证明急诊PCI对老年AMI患者梗死动脉的开通是安全有效的并有良好的近、中期预后。

    关键词： 急性心肌梗死； 血管成形术，经腔，经皮冠状动脉； 老年人

    Observe the effect of Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction in Aged

    LING Wei, et al

    (Chifeng City Hospital, Neimenggu Chifeng 024000, China)

    Abstract： Objective： To observe and assess the safety and efficacy of recent and mid-term outcome of primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI). Method： All patients with AMI(<12h) underwent primary PCI and were divided into the elder group (≥60ys,n＝30)and the younger group (<60ys, n＝31). The basic characteristics, immediate success rate and major adverse cardiac events (MACE) as recurrent angina, myocardial infarction and sudden cardiac death during follow-up were analyzed between two groups. Result： The ratio of patients with heart failure and multi-vessel lesions was higher in the elder group than that in the younger group (40% vs 6% and 52% vs 23%,respectively,P<0.05). Time from adimission to revacularization of infarction related artery (IRA) was longer in the elder group than that in the younger group [(63.86±16.7)min vs (51.16±13.5)min, P<0.05]. The immediate success rate of primary PCI were 97% and 100% in elder group and younger group respectively. 3 patients died in the elder group and none in the younger group(P>0.05). During the follow-up period, 6 recurrent angina, 3 AMI and no sudden cardiac death were reported in the elder group whereas in the younger group only 2 recurrent angina ,one MI and no sudden cardiac death were reported. The MACE ratio was 30% and 10% in the elder and younger group respectively(P<0.05). Conclusion： The immediate success rate of primary PCI and mortality were no difference in patients with AMI in two groups, though elder group MACE ratio is higher than younger, it is better that the safety and efficacy of recent and mid-term outcome of PCI in patients with acute myocardial infarction(AMI). ......