老年冠心病患者接受冠状动脉旁路移植术的临床研究  

Clinical study of coronary artery bypass grafting in elderly patients with coronary heart disease

作　　者：梁林[1] 马小龙[1] 孔晴宇[1] 肖巍[1] 柳佳吉 黄宇 潘峰 耿丹青 赵广鑫 朱俊明[1] 迟立群[1] LIANG Lin;MA Xiaolong;KONG Qingyu;XIAO Wei;LIU Jiaji;HUANG Yu;PAN Feng;GENG Danqing;Junming ZHU;CHI Liqun(Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心外科,100029 [2]重庆遂宁市中心医院

出　　处：《心肺血管病杂志》2022年第6期640-644,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：首都卫生研究与发展专项(2018-2-1052);北京金桥项目(ZZ19006);首都临床诊疗技术研究与转化应用项目(Z20111000550000)。

摘　　要：目的:分析老年冠心病患者接受冠状动脉旁路移植(CABG)术的临床特征和疗效。方法 :回顾性分析2015年1月至2019年12月,北京安贞医院微创心脏外科中心治疗的787例老年冠心病患者临床资料,并进行随访,包括主要不良心脑血管事件(MACCE)、心源性死亡、心肌梗死、心力衰竭、中风和血运重建,以及患者术后服药情况。结果 :患者平均随访时间为3.1年。随访结果显示患者2、4、6和8年无心源性死亡事件的生存率分别为97.3%、94.2%、93.9%、89.0%。发生MACCE(6.4%)、心源性死亡3.9%、心肌梗死0.3%、心力衰竭0.4%,部分患者接受了PCI再血管化治疗(0.6%)。患者冠心病二级预防药服用率较低,尤其是他汀类药物(63.8%)和阿司匹林(89.8%)。结论 :老年冠心病患者接受非体外CABG术的中远期疗效较好。老年患者术后服药依从性较差,需要定期指导合理用药。Objective: To explore the clinical characteristics and efficacy of coronary artery bypass grafting in elderly patients with coronary heart disease. Methods: The clinical data of 787 elderly patients with coronary heart disease treated by minimally invasive cardiac surgery center of Beijing Anzhen Hospital from January 2015 to December 2019 was retrospectively analyzed and followed up, including major adverse cardiovascular and cerebrovascular events(MACCE), cardiac death, myocardial infarction, heart failure, stroke and revascularization, as well as postoperative medication. Results: The average follow-up time was 3.1 years. The follow-up results showed that the 2-year, 4-year, 6-year and 8-year survival rates without cardiac death were 97.3%, 94.2%, 93.9% and 89.0%, respectively. MACCE(6.4%), cardiac death(3.9%), myocardial infarction(0.3%), heart failure(0.4%), and some patients received PCI revascularization(0.6%). The use rate of secondary preventive drugs for coronary heart disease was low, especially statins(63.8%) and aspirin(89.8%).Conclusions: The long-term effect of off-pump coronary artery bypass grafting in elderly patients with coronary heart disease is better. Elderly patients have poor postoperative medication compliance and need regular guidance on rational medication.

关 键 词：冠状动脉旁路移植术 冠心病 老年 疗效 依从性 

分 类 号：R54[医药卫生—心血管疾病]