行经皮冠状动脉介入术老年人的冠状动脉病变特点  

The analysis for the characters of coronary artery lesions of elderly patients with coronary artery disease undergoing percutaneous coronary intervention

作　　者：宋丹[1] 刘华云[1] 朱汉东[1] 王人彭[1] 苏唏[1] 万海燕[1] 

机构地区：[1]武汉亚洲心脏病医院心内科,武汉430022

出　　处：《岭南心血管病杂志》2005年第5期342-344,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的调查老年人行经皮冠状动脉介入术的冠心病患者冠状动脉病变特点。方法对比老年与中青年冠心病患者的临床特点、冠状动脉造影所见病变特点及经皮冠状动脉介入术疗效。结果老年组冠状动脉病变支数为(1.8±0.8)支;中青年组平均为(1.4±0.7)支。差异有统计学意义(P=0.024)。老年组单支病变18例,双支病变14例,3支病变10例;中青年组单支病变33例,双支病变9例,3支病变5例。老年组有心肌梗死史6例(14%),中青年组有心肌梗死史18例(38%),差异有统计学意义(P<0.02)。术后6个月电话随访生存率为99.2%。问卷随访(21±9)个月,其中出现心血管不良事件4例,老年组1例,中青年组3例;6例经皮冠状动脉介入术不满意者,术后症状未改善,其中老年组2例,中青年组4例(P>0.05)。结论老年冠心病患者冠状动脉病变程度较重,多支血管病变多见。应选择合适病例进行经皮冠状动脉介入术治疗。Objectives To analyze the characters of coronary artery lesions of elderly patients with coronary artery disease undergoing percutaneous coronary intervention （PCI）. Methods Diagnosis,the characters of coronary artery lesions and the effect of PCI were analyzed and compared between the elderly and young patients. Results The number of diseased coronary artery in elderly patients （1.8±0.8） was more than that of the young patients （1.4±0.7） （P=0.024）. There was no difference in the accidence rate of main events after PCI between two subsets. In old subset, there were 18 patients with one-vessel disease, 14 patients with two-vessel CAD, 10 patients with three-vessel CAD. But in young patients, there were 33 patients with one-vessel disease, 9 patients with two-vessel disease,and 5 patients with three-vessel disease. There were 6 patients（14.3% ） diagnosed myocardial infarction in elderly patients, but 18 patients （38.3%） in young patients. There was obvious difference between two subsets in one-vessel disease and three-vessel disease （all P〈0.05）. The visit through telephone after 6 months of PCI displayed that the rate survival was 99.2%. The average time followed-up by questionnaire was （20.9±9.2）months, 4 patients（1 from elderly patients;3 from young patients） have happened main events, there was no difference in main events（P 〉0.05）. 5 patients were dissatisfied with PCI because they think the symptoms have not disappeared,2 from elderly patients and 3 from young （P 〉0.05）. Conclusions The vessel lesions of the elderly patients with CAD were severe and always involved with three-vessel disease. It can get well effect to select appropriate patients for PCI.

关 键 词：冠心病 经皮冠状动脉介入术 冠状动脉病变 老年人 

分 类 号：R541.4[医药卫生—心血管疾病]