老年瓣膜性心脏病患者生物瓣与机械瓣置换术后早期和中期预后的对比研究  

The Short-term and Mid-term Outcomes of Elderly Patients With Valvular Heart Disease Undergoing Valve Replacement With Biological or Mechanical Prostheses

作　　者：于振坤 樊红光[1] 郑哲[1] 张桂敏 王珽 王蓓蓓 费俊杰 罗康 胡盛寿[1] YU Zhen-kun;FAN Hong-guang;ZHENG Zhe;ZHANG Gui-min;WANG Ting;WANG Bei-bei;FEI Jun-jie;LUO Kang HU Sheng-shou(Department of Cardiac Surgery,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PU MC,Beijing（100037）,China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院成人外科中心,北京市100037 [2]云南省阜外心血管病医院

出　　处：《中国循环杂志》2018年第11期1098-1101,共4页Chinese Circulation Journal

基　　金：北京协和医学院研究生教育教学改革项目(100232017)

摘　　要：目的:比较老年瓣膜性心脏病患者接受生物瓣与机械瓣置换术后的早、中期结果。方法:对2007-01-09至2010-12-22期间在阜外医院因瓣膜性心脏病接受人工瓣膜置换术的559例年龄大于60岁的老年患者(生物瓣组319例,机械瓣组240例)进行回顾性研究。用倾向性比分对两组患者进行匹配后,两组患者均192例,分析术后早期(30天)及中期平均随访时间(65.97±15.49)个月的心功能、生存率、再次住院率以及血栓与出血相关并发症发生率等。结果:两组患者术后30天内死亡率均为2.1%。两组患者在随访期间的全因性死亡率差异无统计学意义(13.6%vs 13.7%,P=0.98);两组患者的再次住院率的差异也无统计学意义(25.5%vs 35.9%,P=0.17)。两组患者中期生存率的差异无统计学意义(P=0.68);无血栓与出血(脑、内脏及外周血管缺血或出血,不包括皮下出血)生存率两组间差异亦无统计学意义(P=0.78)。结论:老年瓣膜性心脏病患者置入生物瓣和机械瓣的术后早、中期的生存率和再入院率无差异。Objectives： To compare the short-term and mid-term outcomes of elderly patients（〉60 years old） with valvular heart disease（VHD） underwent bioprosthetic or mechanical valve replacement. Methods： Between January 2007 and December 2010, 559 elderly patients underwent valve replacement in Fuwai Hospital, clinical data of these patients were analyzed retrospectively（319 cases with bioprostheses vs 240 cases with mechanical prostheses）. After matching, data from 192 cases in each group were compared. Results： The mortality within 30 postoperative days were similar（2.1% in both groups）. All-cause death during follow up was also similar between the two groups（13.6% vs 13.7%, P=0.98）. There was no statistically significant difference on the hospital readmission rate between the two groups（25.5% vs 35.9%, P=0.17）. No significant difference was found on thromboembolic and hemorrhagic events free survival between the two groups（144 cases vs 138 cases, P=0.78）.Conclusions： Short-term and mid-term survival and readmission rate are similar for the elderly VHD patients receiving bioprosthetic or mechanical valve replacement.

关 键 词：瓣膜性心脏病 瓣膜置换 倾向分值匹配 

分 类 号：R54[医药卫生—心血管疾病]