【摘要】 目的　探讨急诊经皮冠状动脉成形术 (PTCA)及支架置入术对 60岁以上老年急性心肌梗死 (AMI)患者的临床疗效。方法　对 42例老年 AMI患者行急诊 PTCA及支架置入术治疗 (PTCA组 ) ,48例老年 AMI患者行溶栓治疗 (溶栓组 ) ,比较两组住院与随诊期间的情况。结果　PTCA组住院期间死亡 3例 ,抢救成功率 92 .3% ,平均住院天数 1 0 .6d(8.5± 4.2 d) ,2 w左室射血分数 (LVEF) 4 9.5%± 3.2 % ,随诊 1 2个月 ,心绞痛再发 3例 ,再行 PTCA4例 ,冠脉搭桥 3例。溶栓组住院期间死亡 6例 ,抢救成功率 87.2 % ,平均住院天数 2 0 .4 d(1 6.2± 7.5 d) ,2 w LVEF为32 .8%± 6.2 % ,随诊 1 2个月 ,心绞痛再发 1 5例 ,择期 PTCA1 3例 ,冠脉搭桥 3例。结论　对老年 AMI患者急诊 PTCA及支架置入术可即时开通梗死相关血管 ,明显降低 AMI住院死亡率 ,缩短住院天数 ,改善左室功能。更多还原

【Abstract】 Objective To investigate the clinic efficacy of emergency PTCA and coronary stenting in elderly patients (>60 years old) with acute myocardial infarction (AMI). Methods The AMI patients were divided into two groups: PTCA group (42 cases), thrombolysis group (48 cases), comparing the situation of the groups while hospitalization and following up. Results PTCA group: three patients died while hospitalization, the success rate of salvage was 92.3%, average time in hospital was 10.6 d (8.5±4.2 d), LVEF was 49.5±3.2%, following up for twelve months, angina pectoris happened on three patients again, PTCA was taken on four patients again, coronary artery bypass grafting was taken on three patients. Thrombolysis group: six patients died while hospitalization, the success rate of salvage was 87.2%, average time in hospital was 20.4 days (16.2 ± 7.5d), LVEF was 32.8% ± 6.2%, following up twelve months, angina pectoris happened on fifteen cases again, PTCA was taken on thirteen cases again, coronary artery bypass grafting was taken on three cases. Conclusions Emergency PTCA and primary coronary stenting in elderly patients after AMI can open IRA, decrease mortality, shorten time in hospital and improve the function of left ventricle significantly.更多还原