摘要
目的:通过对临床及造影资料的详细分析,研究影响老年AMI患者住院期间死亡的危险因素。方法:420名急性心梗患者,比较年龄<75岁与≥75岁两组的主要死亡率,收集患者的临床资料(包括心血管危因素、合并症、心梗并发症及血液动力学指标)及冠脉造影资料。结果:年龄<75岁者347名(82.6%),≥75岁者73名(17.4%),老年组患者较少,女性较多,Killip分级较高,老年组心血管危险因素及合并症较多,血管病变的支数多,LVEF更低、左室舒末压更高,但TIMI血流0级者少,两组行PCI的比率相近(88%vs 91%P=NS),但老年组成功率低(93%vs 96%P+0.047)。老年组残余狭窄高(21±25%vs 18±21%,P=0.02),达到TIMI3级血流的低(85%vs 92%,P<0.01)。结论:影响住院死亡率最有力的预测因子是年龄≥75岁、最终TIMI分级低、入院时左室射血分数、需IABP支持等因素。
Objective ： To investigate the risk factors of in- hospital mortality in elderly patients with a-cute myocardial infarction （AMI） by analysing the clinical and zngiographic characteristics. Method ：420 patients with AMI, in-hospital mortality were compared in patients aged 〈75 years with those aged ≥75 years. We then collected data concerning cardiac risk factors , comabidities, post-AMI complications, he-modynamin measurements and angiographic parameters. Result：There were 347 patients aged 〈 75 years （82.6% ） ,and 73 patients aged 275 years（17.4%）. Older patients were smaller and more likely to be women and had a higher Killip class at presentation, Cardiac risk fators and comorbidities more prevalent a-mong older patients. Older patients had more diseased vessels,lower LV ejection fration, higher LV end_di-astolic pressure, but fewer vessels with TIMI 0 flow. Older patients were equally likely to undergo percutane-ous intervention （88% vs 91% P=NS） ,but had a lower rate of procedural success（93% vs 96% P＋0. 047）. Overall, final stenosis after percutaneous intervention was higher in the older patients { 21＋25 % vs 18 _＋21% , P=0. 02 ） and the rate of TIMI 3 flow was lower（85% vs 92% ,P〈0.01 ）. Conclusion： The stron-gest predictors of death were aged ≥75 years, lower final TIMI flow, higher Killip class ,need for an intra-aortic balloon pump .
出处
《河北医学》
CAS
2012年第8期1036-1039,共4页
Hebei Medicine
关键词
急性心肌梗死
支架
住院死亡
Acute myocardial infarction
Stent
In-hospital mortality
