梗死前心绞痛对行急诊PCI的老年急性心肌梗死患者预后的影响

摘要

目的:探讨老年首发急性心肌梗死(AMI)患者梗死前1周内心绞痛对其近期预后的影响.方法:87例年龄≥70岁的老年首发AMI且行急诊经皮冠状动脉介入(PCI)治疗的患者按AMI前1周内有无心绞痛发作分为心绞痛组(41例)和无心绞痛组(46例),观察其住院期间心律失常、心力衰竭、心源性休克、肺感染发生率,并比较两组间心功能Killip分级、左室结构、左室射血分数(LVEF)及冠脉病变程度.结果:心绞痛组左心室内径小于无心绞痛组,舒张末径分别为(47.50±6.17)mm及(51.88±5.96)mm(P＜0.05),但两组间LVEF无统计学差异(P＞0.05).心绞痛组住院期间严重心律失常、心力衰竭、心源性休克、肺感染的发生率与无心绞痛组比较,差异无统计学意义(P＞0.05).结论:心肌梗死前心绞痛发作未显示对老年首发心肌梗死患者的保护作用,未能改善患者的近期预后.%Objective: To explore the effect of angina one week before the onset of acute myocardial infarction (AMI)on the short-term prognosis of initial AMI in elderly patients.Methods: Totally 87 initial AMI patients aged ≥ 70 years and undergoing emergency percutaneous coronary intervention (PCI) were divided into two groups: angina pectoris group (n=41)and no angina pectoris group (n=46).Their prevalence of arrhythmia, heart failure,eardiogenie shock and pulmonary infection during the period of hospitalization were observed.And Killip grading of heart functions, left ventricular structure,left ventrieular ejection fraction(LVEF)and the degree of coronary artery lesions of the two groups were compared.Results:Left ventricular demension in angina pectoris group was less than that in no angina pectoris group,left ventricular end-diastolic dimension was (47.50±6.17)mm and(51.88±5.96)mm respectively(P＜0.05 ), but LVEF showed no significant difference in the two groups (P＞0.05).The prevalence of arrhythmia,heart failure,eardiogenie shock and pulmonary infection during the period of hospitalization showed no significant difference in angina pectoris group and no angina pectoris group (P＞0.05).Conclusion:Preinfarction angina has not display protection in elderly patients with initial AMI,and can not improve short-term prognosis of patients.