中文摘要：

目的：探讨高龄ST段抬高心肌梗死（STEMI）患者行直接经皮冠状动脉介入（PCI）术后住院期间的预后情况及其影响因素。方法：回顾性分析2009年1月至2013年12月因STEMI入住我院并行直接PCI的高龄患者（年龄≥75岁）的一般情况、既往史、入院情况、术中及术后情况、并发症等资料,总结分析该类患者住院期间的临床预后,并采用logistic回归模型对可能影响住院期间主要不良心脏事件（MACE）的危险因素进行分析。结果：研究共纳入127例患者,其中男性84例（66.14%）,女性43例（33.86%）,年龄79±3岁,住院时间13.07±7.80天,住院期间MACE的发生率为17.32%,其中死亡4例（3.15%）。单因素logistic回归分析显示入院时心功能（Killip分级）≥2级、完全性房室传导阻滞、窦性停搏与高龄STEMI患者直接PCI术后住院期间MACE的发生相关,具有统计学意义（P〈0.05）。而多因素logistic回归分析显示入院时心功能（Killip分级）和完全性房室传导阻滞是高龄STEMI患者住院期间MACE的危险因素。结论：高龄STEMI患者接受直接PCI治疗总体安全,影响其住院期间MACE的危险因素包括心功能不全和完全性房室传导阻滞。

英文摘要：

Objective： To explore the in-hospital prognosis of very elderly patients with ST-segment elevation myocardial infarction （STEMI） following primary percutaneous coronary intervention （PCI） and its influencing factors. Methods： Elderly patients （〉 75 years old） with STEMI flowing primary PCI admitted in our hospital from January 2009 to December 2013 were sleeted for this study, the general condition, medical history, hospitalized cases, intraoperative and postoperative condition and complications were retrospectively analyzed. The clinical prognosis of these patients during hospitalization was summarized, and a logistic regression model was used to analyze the risk factors of major adverse cardiac events （MACE） during hospitalization. Results： 127 patients were enrolled in this study, including 84 （66.14%） males and 43 （33.86%） females, aging 79± 3 years old, and the length of hospital stay was 13.07±7.80 days. During hospitalization, the occurrence rate of MACE was 17.32%, including 4 cases （3.15%） of death. Single factor logistic regression analysis showed that Killip class≥ 2, complete atrio-ventricular block （CAVB） and sinus arrest were associated with MACE during hospitalization of very elderly STEMI patients after primary PCI （P〈0.05）. Multi-factor logistic regression analysis showed that heart function （Killip classification） and CAVB were risk factors for in-hospital MACE of very elderly STEMI patients after primary PCI. Conclusions： Primary PCI was generally safe for very elderly STEMI patients, heart dysfunction and CAVB were risk factors for the in-hospital MACE of these patients.