高龄急性ST段抬高型心肌梗死患者临床特点的分析

摘要

目的 了解行介入治疗的高龄急性ST段抬高型心肌梗死患者的临床特点及预后.方法 入选2010年1月1日～2014年12月31日入住中国医科大学附属盛京医院心内科确诊为急性ST段抬高型心肌梗死,且行介入治疗的老年患者604例,依据年龄分为老年组(60～79岁)524例和高龄组(≥80岁)80例,收集患者临床基本资料、冠状动脉造影及介入结果、术后出院带药情况,记录终点事件,回顾性分析2组患者临床特点及预后差异.结果 与老年组比较,高龄组术后血流TIMI 3级比例更低(96.3％ vs 99.0％)、平均支架长度更短(31 mm vs 38 mm)、男性、吸烟、术后应用氯吡格雷、β受体阻滞剂比例降低(P＜0.05).2组术后主要不良心血管事件发生率比较,差异无统计学意义(17.6％ vs 21.3％,P＞0.05).结论 高龄急性ST段抬高型心肌梗死患者具有独特的临床特点,其术后主要不良心血管事件发生率与老年患者无显著差异.%Objective To study the clinical characteristics and outcome of very old patients with acute ST-segment elevation myocardial infarction (STEMI) after PCI.Methods Six hundred and four elderly STEMI patients admitted to our hospital from 2010-01-01 to 2014-10-01 were divided into 60-79 years old group (n=524) and ≥80 years old group (n=80).Their general data,coronary angiographic data,PCI data,and end-point events were recorded.Their clinical characteristics and outcome were retrospectively analyzed.Results The incidence of TIMI 3 was lower and the average stent length was shorter in ≥80 years old group than in 60-79 years old group (96.3％ vs 99.0％,31 mm vs 38 mm,P＜0.05).The number of males,cigaret smokers,clopidogrel and β-blocker users was smaller after PCI.No significant difference was found in MACE between the two groups (17.6％ vs 21.3％,P＞0.05).Conclusion ≥80 years old STEMI patients are of their unique clinical characteristics.The incidence of MACE is not significantly different in ≥80 years old STEMI patients and 60-79 years old STEMI patients.