河南省80岁以上急性ST段抬高型心肌梗死患者的早期再灌注治疗情况和住院病死率

摘要

目的 了解河南省80岁以上急性ST段抬高型心肌梗死(STEMI)患者的早期再灌注治疗情况和住院病死率.方法 将河南省17家医院2011-06~2012-06的1633例STEMI住院患者分为年龄≥80岁(126例)和年龄<80岁(1507例)两组,比较两组一般情况、早期再灌注治疗情况、合并用药、住院死亡及出血发生情况. 结果 年龄≥80岁组女性患者、心功能异常和既往合并缺血性脑卒中、心绞痛的比例较高,而血脂异常及吸烟比例较低.年龄≥80岁的STEMI患者早期再灌注比例明显低于年龄<80岁的患者(P<0.05),接受溶栓的比例较低(P<0.05),而直接经皮冠状动脉介入治疗(PCI)的比例两组相似(P>0.05).两组早期再灌注治疗的成功率和发病至再灌注治疗时间比较差异均无统计学意义(P>0.05).年龄≥80岁STEMI患者的住院时间较短,住院病死率较高(P均<0.05).年龄≥80岁是住院死亡的独立危险因素.结论 河南省80岁以上STEMI患者的早期再灌注比例较低,住院病死率较高.%Objective To assess the early reperfusion therapy and in-hospital mortality in octogenarian patients with ST-segment elevation myocardial infarction (STEMI) in Henan province.Methods Data was collected from 1633 patients with STEMI enrolled in 17 hospitals in Henan, from June 2011 to June 2012, and was divided into two groups: octogenarian group (age≥80 years;n=126) and younger group (age<80 years;n=1507).Patient characteristics, management strategy, pharmacological treatments during the admission, in-hospital mortality and bleeding complications were compared between the two groups.Results Octogenarian patients were more female, and with higher proportion of cardiac dysfunction, prior ischemic stroke and prior angina, but lower rate of dyslipidemia and smoking.Compared with younger patients, octogenarian patients had a lower proportion of early reperfusion therapy (P<0.05), especially thrombolysis therapy (P<0.05).The use of primary percutaneous coronary intervention (PCI) was similar between octogenarian and younger groups (P>0.05).There was no difference in the successful rate of early reperfusion or time from symptom onset to reperfusion between two groups (P>0.05).Octogenarian patients had a shorter duration of hospital stay and higher in-hospital mortality (P<0.05).Age ≥80 years was an independent risk factor of in-hospital death.Conclusion Octogenarian patients have a lower proportion of early reperfusion therapy and higher in-hospital mortality.