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目的 探讨 40岁以下青年人及 6 0岁以上老年人急性心肌梗死 (AMI)直接PTCA特点。方法 对 2 7例 40岁以下青年及 34例 6 0岁以上老年AMI患者直接PTCA进行分析。结果 青年组93%为单支病变 ,均无钙化 ,钢丝一次性通过顺利为 10 0 % ,支架置入率低 44 4% ,手术过程短 ,平均(35 2± 10 3)min ,术后恢复顺利。老年组 42 %病例为双支以上病变 ,且钙化病变多见 ,支架置入率高 ,手术过程较青年组长 ,平均 (48 3± 8 4)min。两组PTCA成功率均 10 0 % ,老年组有 2例女性三支病变 ,术后分别于 1天、2天死于泵衰竭。结论 AMI直接PTCA成功率高 ,明显降低病死率 ,对老年人多支复杂病变行直接PTCA应慎重。
Objective To investigate the characteristics of direct PTCA in acute myocardial infarction (AMI) in young people under 40 years old and over 60 years old. Methods Direct PTCA was analyzed in 27 youths under 40 years old and 34 elderly AMI patients over 60 years of age. Results Ninety-three percent of patients in the youth group were single-vessel disease without calcification. The rate of one-off operation was 100%, the stent placement rate was 44.4% and the operation time was short (35 2 ± 10 3 min) smoothly. Forty-two percent of elderly patients with lesions of more than two branches, and more common calcified lesions, stent placement rate, the operation process than the young group, an average of (48 3 ± 8 4) min. Two groups of PTCA success rate was 10%, the elderly group of 2 women with three lesions, respectively, after 1 day, 2 days died of pump failure. Conclusions The success rate of direct PTCA in AMI is high, and the mortality rate is obviously reduced. Direct PTCA should be carefully performed in the complicated complex lesions of the elderly.