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目的探讨经皮冠状动脉介入术(percutaneous coronary intervention,PCI)和非PCI治疗对老年急性心肌梗死患者预后的影响。方法选择金华市人民医院心内科2012年1月—2014年12月老年急性心肌梗死PCI治疗患者80例作为PCI组和老年急性心肌梗死非PCI治疗患者80例作为非PCI组,收集2组心肌梗死患者的临床资料。结果 PCI组的院内死亡率低于非PCI组(P<0.05),PCI组和非PCI组再发心肌梗死、再发心肌缺血和心源性休克的发生率比较差异无统计学意义(P>0.05);ST段抬高型心肌梗死是住院期间院内死亡的独立影响因素(P<0.05),PCI治疗、年龄、性别、吸烟、血脂异常、糖尿病、高血压史不影响住院期间院内死亡情况(P>0.05);1年内,PCI组因充血性心力衰竭再住院率和全因死亡率低于非PCI组(P<0.05),PCI组和非PCI组再发心肌梗死、不稳定性心绞痛、脑卒中、再次血运重建的发生率比较差异无统计学意义(P>0.05);PCI治疗、年龄、性别、吸烟、血脂异常、糖尿病、高血压史、ST段抬高型心肌梗死均不影响1年内因心力衰竭再入院情况(P>0.05);PCI治疗与1年内全因死亡呈负相关(P<0.05),是全因死亡的独立保护因素,年龄、性别、吸烟、血脂异常、糖尿病、高血压史、ST段抬高型心肌梗死均不影响1年内全因死亡(P>0.05)。结论 PCI治疗老年急性心肌梗死患者的院内死亡率、1年内因充血性心力衰竭再住院率、1年内全因死亡率低,PCI治疗是1年内全因死亡的独立保护因素。
Objective To investigate the effect of percutaneous coronary intervention (PCI) and non-PCI on the prognosis of elderly patients with acute myocardial infarction. Methods From January 2012 to December 2014, 80 patients with PCI in elderly patients with acute myocardial infarction and 80 patients with non-PCI patients with acute myocardial infarction in the elderly were enrolled as the non-PCI group. Two groups of myocardial infarction The patient’s clinical data. Results The hospital mortality rate in PCI group was lower than that in non-PCI group (P <0.05). There was no significant difference in the incidence of myocardial ischemia and cardiogenic shock between PCI group and non-PCI group (P > 0.05). ST-segment elevation myocardial infarction was an independent influencing factor of in-hospital mortality during hospitalization (P <0.05). The history of PCI during hospitalization did not affect the in-hospital mortality during PCI, age, gender, smoking, dyslipidemia, (P> 0.05). Within one year, the rehospitalization rate and all-cause mortality rate of PCI group was lower than that of non-PCI group (P0.05), PCI group and non-PCI group had myocardial infarction, unstable angina pectoris (P> 0.05). There were no significant differences in the incidence of stroke and revascularization (P> 0.05). No significant difference was found in the incidence of PCI, age, gender, smoking, dyslipidemia, diabetes mellitus, (P <0.05). There was a negative correlation between PCI treatment and all-cause mortality within 1 year (P <0.05), which was an independent protective factor of all-cause mortality. Age, sex, smoking, dyslipidemia, Diabetes mellitus, history of hypertension, and ST segment elevation myocardial infarction did not affect all causes within 1 year Died (P> 0.05). CONCLUSIONS: In-hospital mortality in patients with senile acute myocardial infarction, rehospitalization due to congestive heart failure in one year, and low all-cause mortality in one year are the independent protective factors for all-cause mortality within one year after PCI.