高龄冠心病患者行冠状动脉介入治疗的风险及疗效评价  

The evaluation of risk and benefits of percutaneous coronary intervention among the aged patients with coronary heart disease

作　　者：李群 李莉娜 程宇彤[3,4] 刘彤[3,4] 

机构地区：[1]清华大学第一附属医院 [2]北京华信医院心脏中心,北京100016 [3]首都医科大学附属北京安贞医院 [4]北京市心肺血管疾病研究所心内科

出　　处：《心肺血管病杂志》2012年第6期666-668,共3页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京安贞医院院长科技发展基金(基金号2011F03);北京市科委首都临床特色应用研究(基金号Z121107001012068)资助

摘　　要：目的:对高龄冠心病患者实施冠状动脉介入治疗风险及疗效进行综合评价。方法:总结分析年龄≥75岁(75～91岁)的高龄冠心病患者98例,<75岁399例,分别分析经皮冠状动脉成形术(PCI)前、术中、术后情况及并发症等。结果:≥75岁组患者术前合并心血管疾病的危险因素种类较<75岁组多〔(4.5±1.75)vs.(2.2±0.68),P<0.05〕,急性冠状动脉综合征(ACS)所占比例,两组之间差异无统计学意义(18.4%vs.20.6%,P>0.05);经桡动脉入路所占比例≥75岁组为56.1%,<75岁组为66.2%,差异无统计学意义;≥75岁组PCI时间长于<75岁组〔(59.1±10.4)m vs.(53.1±11.8)m,P<0.05〕;PCI成功率(96.9%vs.99.7%,P=0.026);术后在院期间病死率、PCI相关并发症发生率,两组差异均无统计学意义,术后在院期间心绞痛再发率,差异无统计学意义(3.1%vs.2%,P>0.05)。结论:高龄冠心病患者中行PCI术,可提高老年患者的生存质量,有明显获益;并且PCI术并发症与手术风险与低年龄组无明显差异,安全性好。Objective：To evaluate the risk and benefits in aged patients underwent percutaneous coronary intervention（PCI）.Methods：The data of 497 patients who underwent PCI were summarized.Among those,98 patients were more than 75 years old and 399 with age less than 75 years.Results：≥75 years group suffered more systemic diseases compared to 75 group（（4.5±1.75）vs.（2.2±0.68）,P〈0.05）;the difference of the prevalence of ACS between the two groups was statistically insignificant（18.4% vs.20.6%,P〈0.05）;The trans-radial approach were applied among 56.1% patients aged more than 75 years while 66.2% in 75 group without significant difference;The elder group had longer duration of process and little lower PCI success rate compared with 75 group（（59.1±10.4）m vs.（53.1±11.8）m,P〈0.05）;（96.9% vs.99.7%,P=0.026）.The mortality,prevalence of complication and the recurrence of angina were not found significant difference between the two groups.Conclusion：To perform PCI among the aged patients with coronary heart disease are relatively safe and it can improve the life quality and have apparent benefits.

关 键 词：高龄 冠状动脉疾病 冠状动脉介入治疗 风险 疗效 

分 类 号：R54[医药卫生—心血管疾病]