老年冠心病介入治疗的疗效及对心功能的影响  

Efficacy of Percutaneous Coronary Intervention of Senile Coronary Heart Disease and Its Influence on Cardiac Function

作　　者：申强[1] 包忠武[1] 孙秀才[1] 蒋军军[1] 

机构地区：[1]湖南省怀化市第一人民医院心内科,湖南怀化418000

出　　处：《医学临床研究》2011年第4期684-686,690,共4页Journal of Clinical Research

摘　　要：【目的】探讨经皮穿刺冠状动脉介入治疗（PCI）对老年冠心病（cHD）的疗效及心功能的影响。【方法】比较青中年（45～59岁，60例）和老年（60～85岁，62例）CHD患者的临床和冠脉介入治疗特点、PCI即刻成功率及并发症、PCI术后6个月内主要心脏事件（MACE）和终点事件的发生及PCI术前，术后6个月心功能的改变。【结果】老年组双支、多支及复杂病变明显增多，Gesini积分明显增高（P〈0．05，P〈0．01）。与青中年组相比，PCI的即刻成功率为98．38％与青中年组（198．33％）相比无统计学差异。老年组完全血运重建的比例低于青中年组（P〈0．05）；与治疗前比较，青中年组和老年组患者PCI术6个月后：LVDD均缩小（P〈0．05），LVEF与E／A均升高（P〈0．05），6-MWD距离均提高（P〈0．05），但老年组变化幅度更大（P〈0．05）。【结论】有适应证的老年患者能耐受PCI，PCI即时成功率、院内无事件生存率与年轻患者相当，年龄不是PCI的禁忌证，且老年CHD患者PCI术后对心功能的改善较青中年患者更加显著。[Objective]To explore the efficacy of percutaneous coronary intervention（PCI） of senile coronary heart disease（CHD） and its effect on cardiac function. [Methods] The clinical features, the immediate success rate of PCI, the incidence of complications, main cardiac event（MACE） at 6 months after PCI and terminal event and the changes of heart function before and 6 months after PCI in young and middle-aged CHD patients（45~59 years old, n ：60） and old CHD patients（60 to 85 years old, n ：62） were compared, [Results] In older age group, two branches and multiple branches of lesions and complex lesions increased, and Gesini score raised（ P 〈0.05, P 〈0.01）. The immediate success rate of PCI in older age group and young and middle-age group was 98.38% and 198.33%, respectively, but there was no statistical difference between two groups. The rate of complete revascularization in older age group was lower than that in young and middle-age group（ P 〈0.05）. Compared with before treatment, the LVDD in two groups decreased at 6 months after PCI（ P 〈0.05）, but LVEF and E/A increased（ P 〈0.05）, and the distance of 6-MWD also raised（ P 〈0.05）, and those in older age group changed more significantly（ P 〈0.05）. [Conclusion] Elderly patients with indications can tolerate PCI, and their immediate success rate of PCI and event-free survival rate in hospi tal are the same as young patients. Age is not the contraindication for PCI. The improvement of cardiac function of senile CHD patients after PCI is better than young and middle-age patients.

关 键 词：冠状动脉疾病/治疗 

分 类 号：R543.3[医药卫生—心血管疾病]