年轻冠心病患者冠状动脉裸支架术即刻及长期疗效随访  

Short and Long-term Follow-up of Young Patients Underwent Coronary Bare Metal Stent Implantation.

作　　者：赵华[1] 张奇[2] 张建盛[2] 张瑞岩[2] 胡健[2] 张宪[2] 沈卫峰[2] 

机构地区：[1]杭州市余杭区妇幼保健院心血管内科,浙江杭州311100 [2]上海瑞金医院心内科,上海200025

出　　处：《心脑血管病防治》2006年第3期155-157,共3页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的评估年轻冠心病患者(<45岁)冠状动脉(冠脉)内支架术的长期疗效。方法选65例年龄<45岁的患者接受冠脉内支架术治疗(年轻组),随机同期选取65例年龄>45岁行冠脉内支架术患者作为对照组。比较两组一般情况、冠脉病变、介入治疗及3年临床随访情况。结果年轻组患者心梗68%比对照组35%多见,P<0.05;单支冠脉病变患者明显增多(83%比57%,P=0.001);介入治疗后达到完全血运重建者增多(95%比78%,P=0.004)。平均随访87±13月,年轻组患者再发胸痛及再次住院发生率明显高于对照组(分别为35%和17%,P=0.02,28%和14%,P=0.05),新生病变发生率明显高于对照组(分别为23%和9%,P=0.03;35%和17%,P=0.02)。结论年轻患者冠脉裸支架术完全血运重建率高,术后心脏事件的发生主要由新生冠脉病变引起。冠脉支架植入术可作为年轻冠心病患者的可选治疗方式之一。Objective To evaluate the long - term effect of coronary stent in young patients （ 〈 45 years ） with coronary artery disease.Methods From July 1996 to March 2002, 65 patients younger than 45 years undergone coronary stent implantation were inchrded as younger group. Another 65 eontemporary older patients （ 〉 45 years） undergone coronary stent were served as the control group. The general characteristics, coronary angiography, interventional, and follow- up information were compared between these two groups.Results Compared with the control group, the young group patients were presented with much more myocardial infarction （68 % Vs 35 %, P 〈 0.05） and single - vessel disease （83 % Vs 57 %, P = 0,001 ）. There were more patients with complete revascularization in the young group （95% Vs 78%, P= 0.004）. Daring a mean 87 ± 13 months＇ follow - up, recurrent angina and readmission rate were higher in the young group, as well as the incidence of MACE. Repeat CAG revealed much more de novo lesions in the young group （44%Vs 11%, P= 0.02） and higher rate of restenfing. Conclusions Due to the accelerated process of coronary atherosclerosis in young patients, coronary bare metal stent implantation should be regarded as one of the available choices of treatment.

关 键 词：冠心病 支架术 年轻者 疗效 

分 类 号：R541.4[医药卫生—心血管疾病]