冠状动脉支架置入术治疗老年单支血管病变冠心病的临床疗效观察  

Clinical observation of coronary stent implantation in the treatment of coronary heart disease with coronary artery disease in elderly patients

作　　者：曹勇[1] 吴张平 石国平[1] 吴超然[2] CAO Yong;WU Zhangping;SHI Guoping;WU Chaoran(Rugao People＇s Hospital,Rugao,yiangsu 226500,China;Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]如皋市人民医院,江苏如皋226500 [2]四川大学,四川成都610041

出　　处：《安徽医药》2018年第9期1678-1681,共4页Anhui Medical and Pharmaceutical Journal

基　　金：国家自然科学基金项目(81471141)

摘　　要：目的研究冠状动脉支架置入术治疗老年单支血管病变冠心病的临床疗效。方法选取如皋市人民医院2014年6月至2015年8月间收治的老年单支血管病变冠心病患者78例,采用随机数字表法将其分为对照组和观察组,每组各39例。对照组患者接受药物保守治疗,观察组患者则接受冠状动脉支架置入术治疗。分别比较两组患者治疗前后的心肌纤维化指标、心脏结构及功能指标,同时观察冠心病生活质量测评专用量表(SAQ)评分。结果治疗后,观察组的血清I型前胶原(PCI)(149.36±13.25)μg·L-1、Ⅲ型前胶原(PCⅢ)(47.23±5.12)μg·L-1、层黏蛋白(LN)(181.33±13.20)μg·L-1、透明质酸(HA)(132.24±11.87)μg·L-1以及醛固酮(ALD)(158.72±14.88)ng·L-1水平均明显低于对照组(188.67±16.53)、(69.71±6.38)、(207.04±16.72)、(170.41±14.87)μg·L-1,(231.07±26.21)ng·L-1(t=13.64,20.19,8.84,14.74,17.64;均P<0.01);观察组的左心室射血分数(LVEF)(63.40±6.18)%和6 min步行试验(6MWD)(402.13±31.16)m明显高于对照组(55.18±6.26)%、(341.46±36.28)m(t=7.03,10.43;均P<0.01);左心室舒张末期内径(LVEDD)(40.14±4.85)mm和N末端B型脑钠肽前体(NT-pro BNP)(47.76±5.63)ng·L-1明显低于对照组(47.76±5.63)mm、(2.98±1.44)ng·L-1(t=7.54,5.72;均P<0.01);观察组的SAQ评分明显高于对照组(P<0.01)。结论冠状动脉支架置入术治疗老年单支血管病变冠心病的临床疗效显著,能有效抑制心肌纤维化,改善心脏功能及结构,并能提高患者生活质量,值得在临床推广。Objective To study the clinical curative effect of coronary artery stenting in the treatment of senile coronary heart disease and single vessel disease in elderly patients. Methods The subjects were 78 elderly patients with single vessel disease coronary heart in our hospital from June 2014 to August 2015,which were randomly divided into control group and observation group,39 cases in each group. The control group received drug treatment,the observation group was treated with coronary artery stenting respectively. The myocardial fibrosis,cardiac structure and heart function index,coronary heart disease and observe the quality of life assessment scale（SAQ） score were compared between two groups before and after treatment. Results After treatment,the observation group of the serum PCI（149. 36 ± 13. 25） μg·L-1,PC Ⅲ（47. 23 ± 5. 12） μg·L-1,LN（181. 33 ± 13. 20） μg·L-1,HA（132. 24 ± 11. 87） μg·L-1 and ALD（158. 72 ± 14. 88） ng·L-1 levels were significantly lower than that of control group（188. 67 ± 16. 53）,（69. 71 ±6. 38）,（207. 04 ± 16. 72）,（170. 41 ± 14. 87） μg · L-1,（231. 07 ± 26. 21） ng·L-1（t = 13. 64,20. 19,8. 84,14. 74,17. 64; P〈0. 01）,LVEF（63. 40 ± 6. 18） % and 6 MWD（402. 13 ± 31. 16） m were significantly higher than that of control group（55. 18 ±6. 26） %,（341. 46 ± 36. 28） m（t = 7. 03,10. 43; P〈0. 01）,LVEDD（40. 14 ± 4. 85） m and NT-pro BNP（47. 76 ± 5. 63） ng·L-1 were significantly lower than that of the control group（47. 76 ± 5. 63） mm,（2. 98 ± 1. 44） ng·L-1（t = 7. 54,5. 72; P〈0. 01）,observation group of the SAQ score was significantly higher than the control group（P〈0. 01）. Conclusion The clinical curative effect of coronary artery stenting in the treatment of elderly patients with single vessel disease coronary heart disease significantly can effectively inhibit myocardial fibrosis and improve the cardiac function and structure,and improve the patient life Quality,which is worth in

关 键 词：冠状动脉支架置入术 单支血管病变 冠心病 临床疗效 

分 类 号：R541.4[医药卫生—心血管疾病]