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目的探讨老年人急性心肌梗死(AMI)后冠状动脉自发再灌注(SR)的影响因素。方法 77例首次发作AMI且未经静脉溶栓及其它再灌注治疗的老年患者,根据选择性冠状动脉造影(CAG)检查结果分成自发再灌注组(TIMI≥2级)与无自发再灌注组(TIMI 0～1级),采用Logistic回归分析寻找对SR影响有意义的因素。结果①急性心肌梗死后冠状动脉自发再灌注率为41.6%。②梗死前心绞痛(OR=7.077,95%CI:1.810,27.669)、起病至开始治疗时间的长短(OR=0.124,95%CI:0.048,0.326)与SR的发生有关。结论未经静脉溶栓及其它再灌注治疗的老年AMI患者存在一定的自发再灌注率,梗死前心绞痛的发生,使SR的发生可能性增大;起病至开始治疗时间延长,使SR发生可能性减小。
Objective To investigate the influencing factors of spontaneous reperfusion (SR) in elderly patients with acute myocardial infarction (AMI). Methods Seventy-five elderly patients with first episode AMI who were not treated with intravenous thrombolysis and other reperfusion were divided into spontaneous reperfusion group (TIMI≥2 grade) and spontaneous reperfusion group (n = 6) according to the results of selective coronary angiography (CAG) TIMI level 0 ~ 1), Logistic regression analysis was used to find out the factors influencing SR. Results ① The spontaneous reperfusion rate of coronary artery after AMI was 41.6%. The pre-infarction angina (OR = 7.077, 95% CI: 1.810, 27.669), the length of time from the onset to the beginning of treatment (OR = 0.124, 95% CI: 0.048,0.326) was related to the occurrence of SR. Conclusion There is a certain degree of spontaneous reperfusion rate and angina pectoris in aged AMI patients without intravenous thrombolysis and other reperfusion, which makes the possibility of SR increased. The incidence of SR may be increased from the onset to the start of treatment. Reduce sex