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目的观察直接经皮冠状动脉成形术(PTCA)治疗老年(≥70岁)急性心肌梗死的临床疗效。方法对70例发病时间12 h以内,70岁及以上急性心肌梗死患者行直接PTCA(必要时冠脉内植入支架);并随机选择同期72例发病时间12 h以内,未行溶栓或PTCA的70岁及以上急性心肌梗死患者进行比较和1年随访。结果治疗组中68例患者术后即刻血流皆达TIMIⅡ~Ⅲ级,手术成功率97.14%,治愈率98.57%,1年内梗塞后心绞痛发生率18.57%,因心脏原因再住院率21.43%;对照组死亡9例,治愈率87.50%,1年内梗塞后心绞痛发生率33.33%,因心脏原因再住院率43.06%,两组差异有显著意义。1年随访治疗组心功能明显较对照组为优。结论直接PTCA治疗老年(≥70岁)急性心肌梗死治愈率高,能更好地消除梗塞后心绞痛,保护患者心功能,减少心血管事件。
Objective To observe the clinical effect of direct percutaneous transluminal coronary angioplasty (PTCA) in the treatment of elderly patients (≥70 years) with acute myocardial infarction. Methods 70 patients with onset of myocardial infarction within 12 hours and 70 years of age and above underwent direct PTCA (when necessary, coronary stents were implanted); 72 patients were randomly selected within 12 hours of onset, without thrombolysis or PTCA Of 70-year-old and above acute myocardial infarction patients were compared and 1-year follow-up. Results 68 patients in the treatment group had immediate postoperative TIMI grade Ⅲ ~ Ⅲ, the success rate was 97.14%, the cure rate was 98.57%, the incidence of post-infarction angina in one year was 18.57%, and the rate of rehospitalization in hospital was 21.43% In the group of 9 deaths, the cure rate was 87.50%. The incidence of post-infarction angina in one year was 33.33%. The rate of rehospitalization due to heart disease was 43.06%. There was significant difference between the two groups. 1-year follow-up treatment group was significantly better than the control group heart function. Conclusion The direct PTCA treatment of elderly (≥ 70 years) acute myocardial infarction cure rate, can better eliminate post-infarction angina, protect the patient’s cardiac function and reduce cardiovascular events.