老年冠心病患者冠状动脉慢性完全闭塞病变介入治疗及预后分析  

Analysis of percutaneous coronary intervention and prognosis for chronic total occlusion in elderly patients with coronary heart disease

作　　者：邱茹洁[1] 张存泰[2] 徐承义[1] 何蕾[1] 刘成伟[1] 吴明祥[1] 

机构地区：[1]武汉亚洲心脏病医院,武汉430030 [2]华中科技大学同济医学院附属同济医院

出　　处：《内科急危重症杂志》2015年第1期12-15,23,共5页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨老年冠心病患者合并冠状动脉慢性完全闭塞病变(CTO)行经皮冠状动脉介入治疗(PCI)的疗效。方法:回顾性分析我院经冠脉造影检查证实CTO并行PCI治疗的患者232例,按年龄分组,对比分析老年组108例,年龄≥60岁,平均(66.6±5.4)岁,中青年组124例,年龄<60岁,平均(51.3±6.3)岁患者的临床特征、冠状动脉造影血管病变特点、闭塞血管开通率、围术期并发症及预后情况。结果:老年组患者冠心病家族史比例低于中青年组,与PCI相关的心肌梗死的发生率较中青年组高(P<0.05)。但2组患者的闭塞病变血管支数及部位、平均造影剂用量、手术时间、应用导丝数量及球囊数量、支架植入数、闭塞病变开通率、随访术后心功能改善情况、主要不良心血管事件发生率差异均无统计学意义(P<0.05)。结果:老年冠心病患者合并CTO病变行介入治疗的手术成功率以及主要不良心血管事件发生率与中青年CTO患者比较无差异,但术后心功能明显改善。Objective： To explore the therapeutic effect of percutaneous coronary intervention（ PCI） in elderly patients with coronary heart disease（ CHD） complicated with chronic total occlusion（ CTO）. Methods： Two hundred and thirty-two patients confirmed as CTO by coronary angiography and underwent PCI in our hospital were analyzed retrospectively. Patients were divided according to age,108 cases belonged to the elderly group,with age≥60 years old（ 66. 6 ± 5. 4）,124 cases as the young group,age 〈60（ 51. 3 ± 6. 3）. Clinical characteristics,characteristics of vascular lesions in coronary angiography,recanalization rate of occlusive vessels,perioperative complications,and prognosis etc. were analyzed and compared between two groups. Results： Family history of CHD in elderly group was significantly lower than that of the young group,the incidence of PCI associated myocardial infarction was higher in the elderly group than that in young group（ P 〈0. 05）. However,there were no significant differences in location and number of branches of occlusive vessels,the average amount of contrast agent used,the time of operation,the number of guidewire and balloon used,the number of stents implanted,the recanalization rate of occlusive vessel,postoperative follow-up cardiac function improvement and the incidence of main cardiovascular event（ P 〈0. 05）. Conclusions： There were no significant differences in the success rate of PCI and the incidence of main cardiovascular events between the elderly and young patients with coronary heart disease,and the heart function was also improved obviously after PCI in elderly patients.

关 键 词：老年人 冠状动脉 慢性完全闭塞病变 经皮冠状动脉介入治疗 回顾性分析 

分 类 号：R543.3[医药卫生—心血管疾病]