经皮冠状动脉介入治疗对老年多支慢性完全闭塞病变患者生活质量的影响  

The eff ect of percutaneous coronary intervention on the quality of life in elderly patients with multivessel chronic total occlusion

作　　者：陈焱 赵帅 杨丽[1] 朱伯达 马炳琦 王嘉仪 邹一鸣 胡文涛 李成祥 廉坤 韩鹏 CHEN Yan;ZHAO Shuai;YANG Li;ZHU Bo-da;MA Bing-qi;WANG Jia-yi;ZOU Yi-ming;HU Wen-tao;LI Cheng-xiang;LIAN Kun;HAN Peng(Department of Cardiology,the First Affiliated Hospital of PLA Air Force Military Medical University,Xi′an 710032,China)

机构地区：[1]中国人民解放军空军军医大学第一附属医院心血管内科,陕西西安710032 [2]中国人民解放军海军第九七一医院心血管内科 [3]中国人民解放军西部战区空军医院心血管内科 [4]中国人民解放军空军航空大学初级飞行训练基地 [5]中国人民解放军空军军医大学基础医学院学员队 [6]中国人民解放军联勤保障部队第九八一医院心血管内科

出　　处：《中国介入心脏病学杂志》2023年第8期570-578,共9页Chinese Journal of Interventional Cardiology

基　　金：空军军医大学临床研究项目(2022LC2208);西京医院临床新技术新业务项目(XJGX15Y39);空军军医大学教学改革研究项目(KJJYDXYB015)。

摘　　要：目的探讨冠状动脉慢性完全闭塞(CTO)病变经皮冠状动脉介入治疗(PCI)对老年多支CTO病变患者症状和生活质量的影响。方法连续纳入2018年4月至2021年4月于中国人民解放军空军军医大学第一附属医院成功接受择期CTO-PCI的多支CTO病变患者284例,并根据年龄分为老年组(>65岁,106例)和非老年组(≤65岁,178例)。收集两组患者的术前资料、术前生活质量评估、冠状动脉造影结果和术中数据、院内并发症及1个月和1年的随访数据。通过分析患者CTO-PCI术后1个月和1年后欧洲五维健康量表(EQ-5D)、生命质量SF-12量表和西雅图心绞痛量表(SAQ)分数与主要不良心血管事件(MACE)发生情况,评估成功CTO-PCI对老年多支CTO病变患者的生活质量和症状的影响。结果老年组与非老年组成功行CTO-PCI术后1个月MACE发生率分别为15.53%和10.98%,术后1年MACE发生率分别为23.71%和15.95%,差异均无统计学意义(均P>0.05)。两组患者术后1个月和1年SAQ量表的心绞痛稳定性(SAQ-AS)、心绞痛频率(SAQ-AF)、治疗满意度(SAQ-TS)明显改善,老年组术后1个月和1年SAQ量表的疾病感知(SAQ-DP)也明显改善,差异均有统计学意义(均P<0.05)。老年组术后1年SAQ量表的身体限制(SAQ-PL)[0(–15.56,11.11)比2.22(–8.89,13.33),P=0.021]和SAQ-AS[12.50(0,50.00)比25.00(0,50.00),P=0.019]评分变化量小于非老年组,差异均有统计学意义。两组患者术后1个月和1年EQ-5D评分较术前均显著升高(均P<0.05),但两组间比较差异均无统计学意义(均P>0.05)。两组患者术后1个月和1年SF-12量表的身体功能成分得分(PCS)均较术前升高(均P<0.001),老年组术后1个月的心理功能成分得分(MCS)也较术前升高[(55.91±3.99)比(53.76±6.68),P=0.005],差异均有统计学意义。结论成功的CTO-PCI可以显著缓解老年多支CTO病变患者症状并改善其生活质量,对老年多支CTO病变患者及时行CTO-PCI是相对安全且必要的。Objective To investigate the effects of percutaneous coronary intervention(PCI)on symptoms and quality of life in elderly patients with chronic complete occlusion of coronary arteries(CTO).Methods A total of 284 patients with multiple CTO lesions who successfully underwent elective CTO-PCI in the First Affiliated Hospital of the PLA Air Force Military Medical University from April 2018 to April 2021 were included,and divided into the elderly group(106 cases)and the non-elderly group(178 cases)according to age>65 years.Preoperative data,preoperative quality of life assessment,coronary angiography results and intraoperative data,inhospital complications and 1-month and 1-year follow-up data were collected.The eff ects of successful CTO-PCI on quality of life and symptoms in elderly patients with multiple CTO lesions were evaluated by analyzing the European Five-Dimensional Health Scale(EQ-5D),SF-12,and Seattle Angina Questionnaire(SAQ)scores and the occurrence of major adverse cardiovascular events(MACE)at 1 month and 1 year after CTO-PCI.Results The incidence of MACE in the elderly group and the non-elderly group was 15.53%and 10.98%one month after CTO-PCI,and 23.71%and 15.95%one year after CTO-PCI,respectively,with no statistical significance(P>0.05).The measurement of angina stability(SAQ-AS),angina frequency(SAQ-AF),and treatment satisfaction(SAQ-TS)were signifi cantly improved by SAQ in the two groups of patients at 1 month and 1 year after surgery.The measurement of disease perception(SAQ-DP)by SAQ in the elderly group at 1 month and 1 year after surgery was also signifi cantly improved,and the diff erences were statistically significant(both P<0.05).The changes in SAQ measurement of physical limitation(SAQ-PL)[0(–15.56,11.11)vs.2.22(–8.89,13.33),P=0.021]and SAQ-AS[12.50(0,50.00)vs.25.00(0,50.00),P=0.019]scores in the elderly group after 1 year of surgery were smaller than those in the non elderly group,and the diff erences were statistically signifi cant.The EQ-5D scores of the two groups of patients at

关 键 词：慢性完全闭塞 多支闭塞 老年 临床症状 生活质量 

分 类 号：R541[医药卫生—心血管疾病]