老年冠心病患者介入治疗血运重建方式临床疗效分析  

Interventional revascularization therapy for the reconstruction of blood circulation in aged patients with coronary heart disease:analysis of clinical curative effect

作　　者：于亚梅[1] 余云华[2] 李然[1] 俞宁[3] 沈明[1] 鲍礼智[1] 郑兴[1] YU Ya-mei YU Yan-hua LI Ran YU Ning SHEN Ming BAO Li-zhi ZHENG Xing(Department of Cardiovasology, Affiliated Changhai Hospital, Second Military Medical University, Shanghai 200433, Chin)

机构地区：[1]第二军医大学附属长海医院心血管内科,上海200433 [2]南京军区福州总医院干部病房二科 [3]南京政治学院上海校区干休所卫生所

出　　处：《介入放射学杂志》2017年第1期6-9,共4页Journal of Interventional Radiology

基　　金：上海市科委科技支撑项目(13411950302)

摘　　要：目的探讨接受经皮冠状动脉介入治疗(PCI)伴多支病变高龄冠心病患者达到完全血运重建(CR)或部分血运重建(ICR)对临床预后的影响。方法连续纳入2015年1月至2015年9月确诊为冠状动脉多支病变并接受PCI高龄患者(≥75岁)257例,根据PCI情况分为CR组与ICR组。对比两组患者临床基本资料、PCI情况、院内及随访期间主要心脑血管不良事件(MACCE)。结果 CR组患者171例(66.53%),ICR组患者86例(33.47%)。ICR组患者伴有高血压病史、糖尿病病史,入院诊断急性非ST段抬高型心肌梗死、闭塞病变,术后1、3个月出现胸闷、心慌等不适症状及二次住院率比例均明显高于CR组(P<0.05)。两组术后院内、术后1、3、6个月MACCE发生率差异均无统计学意义(P>0.05)。结论伴多支病变高龄冠心病患者ICR并未增加PCI术后MACCE风险,但二次住院率与术后不适症状发生率增加,远期预后有待进一步观察。Objective To investigate the effect of percutaneous cardiac intervention （PCI） on the clinical prognosis in aged patients with coronary heart disease （CHD） involving multiple coronary arteries who obtained complete revaseularization （CR） or incomplete revascularization （ICR） after PCI. Methods A total of consecutive 257 aged patients （I〉75 years old） with confirmed CHD that involved multiple coronary arteries, who were admitted to authors＇ hospital during the period from January 2015 to September 2015 to receive PCI, were enrolled in this study. Based on the complete revascularization （CR） or incomplete revascularization （ICR） after PCI, the patients were divided into CR group and ICR group. The basic clinical data, PCI parameters and the occurrence of major adverse cardiovascular and cerebrovascular events （MACCE） in hospitalization days and in the follow-up period were compared between the two groups. Results CR group included 171 patients （66.53%） and ICR group included 86 patients （33.47%）. The hypertension history, diabetes history, diagnosis of acute non-ST segment elevation myocardial infarction or myocardial occlusion disease at admission, chest tightness, palpitation and other discomfort symptoms occurring in one and 3 months after PCI, and re-hospitalization rate in ICR group were significantly higher than those in CR group （P〈0.05）. No statistically significant differences in the incidence of MACCE during hospitalization days and at one, 3 and 6 months after PCI existed between the two groups （P〉0.05）. Conclusion In aged patients with CHD that affects mukiple coronary arteries, ICR does not increase the risk of MACCE after PCI, although the re-hospitalization rate and the incidence of postoperative discomfort symptoms will be increased. The long-term prognosis needs to be further studied.

关 键 词：高龄 经皮冠状动脉介入治疗 完全血运重建 部分血运重建 预后 

分 类 号：R541.4[医药卫生—心血管疾病]