老年女性急性ST段抬高型心肌梗死患者行急诊PCI的临床特点及冠状动脉病变特点分析

Clinical features and coronary lesion characteristics in elderly women with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

摘要:

目的 探讨急性ST段抬高型心肌梗死（STEMI）行急诊经皮冠状动脉介入治疗（PCI）的老年女性患者临床及冠脉病变特点。方法 回顾性分析了2006年至2012年我院连续收入的首次诊断为STEMI并接受急诊PCI术的女性患者366例。根据年龄分为两组：老年组（≥65岁；n＝211）和非老年组（＜65岁；n＝155）。分析两组患者临床及冠脉病变特点。结果 与非老年组患者相比，老年组中糖尿病发生率和空腹血糖值均显著较高（P＜0.05），吸烟者的比例和肾小球滤过率显著较低（P＜0.05），老年组患者冠脉三支病变率显著增加（P＜0.05），靶血管为左前降支（left anterior descending branch，LAD）的概率显著降低（P＜0.05）。老年组和非老年组患者接受急诊PCI的成功率分别为98.58%和98.87%。结论 不同年龄阶段的女性STEMI患者具有不同的危险因素特点，老年女性STEMI患者较非老年女性患者，冠状动脉病变更为复杂。

Abstract:

Objective To explore the clinical features and coronary lesion characteristics in the elderly female patients diagnosed as acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). Methods A retrospective study was conducted on 366 consecutive female patients who were first diagnosed as acute STEMI and underwent primary PCI in our hospital from 2006 to 2012. The patients were divided into the aged group (≥65 years old, n＝211) and the non-aged group (＜65 years old, n＝155). The clinical features and coronary lesion characteristics of the 2 groups were analyzed. Results Compared with the non-aged group, the aged group had significantly higher incidence of diabetes, higher fasting blood glucose, lower percentage of smokers, lower glomerular filtration rate, larger amount of triple-vessel disease, and less involved lesions in the left anterior descending branch (LAD) (all P＜0.05). The success rates of PCI in the aged group and the non-aged group were 98.58% and 98.87%, respectively. Conclusion Female STEMI patients have different characteristics in risk factors among different ages. The aged female elderly patients have more complicated coronary lesions than the non-aged ones.