【摘要】 目的　评价老年急性心肌梗死 (AMI)患者梗死相关动脉支架置入术的疗效及安全性。　方法　对 4 1例年龄≥ 70岁的老年急性心肌梗死患者在发病 12h以内行梗死相关动脉直接经皮冠状动脉腔内成形术 (PTCA)加冠状动脉内支架置入术。梗死相关动脉 :前降支 2 1例 (5 1 2 % ) ,回旋支 7例 (17 1% ) ,右冠状动脉 13例 (31 7% )。心肌梗死溶栓治疗临床试验 (TIMI)血流 :0级 2 9例 ,1级 7例 ,2级 5例。　结果　 4 1例患者梗死相关动脉共置入支架 4 8个 ,术中死亡 1例 ,死于心源性休克 ,手术成功率 97 6 % (40 / 4 1)。术后TIMI血流 3级为 37例 (90 2 % )。住院期间死亡 1例 ,死于肾功能衰竭。临床总成功率为 95 1% (39/ 4 1)。随访 36例 ,1例出现心绞痛 ,心血管造影证实为再狭窄 ,行切割球囊成形术 ;1例出院后因充血性心力衰竭再次入院治疗 ;其余 34例未再发心绞痛。　结论　老年AMI患者梗死相关动脉PTCA加支架置入术成功率高、并发症低 ,近期临床疗效确切更多还原

【Abstract】 Objective To evaluate the clinical efficacy of primary intracoronary stenting in the infarct related artery in elderly patients after acute myocardial infarction(AMI). Methods Percutaneous transluminal coronary angioplasty(PTCA) plus primary coronary stenting was performed for 41 AMI patients(≥70 years) within 12 hours from the onset of chest pain. Infarct related arteries were left anterior descending artery in 21 patients(51 2%), left circumflex in 7(17 1%), right coronary artery in 13(31 7%). Thrombolysis in myocardial infarction (TIMI) showed that blood flow was grade 0 in 29 patients, grade 1 in 7, grade 2 in 5. Results Forty eight stents were implanted in the infarct related artery for 41 patients. One patient died of cardiac shock during the procedure, and the success rate was 97 6%(40/41). Grade 3 of blood flow after TIMI was gained in 37 patients(90 2%). One patient died of renal failure while hospitalizing. The clinical successful rate was 95 1%(39/41). Thirty six patients were followed up, 1 patient with restenosis of infarct related artery was performed cutting balloon angioplasty, and 1 patient with congestive heart failure was rehospitalized. Other 34 patients did not manifested angina pectoris. Conclusions Primary coronary stenting for the infarct related artery in elderly patients after AMI is safe and effective with a high successful rate and less complications.更多还原