高龄人群发生冠心病的影响因素及PCI术的疗效分析  

Influencing factors of coronary heart disease in advanced aged population and therapeutic effect of PCI

作　　者：沈玉 杨雪梅[1] 杨露[1] 游桂英[1] SHEN Yu;YANG Xue-mei;YANG Lu;YOU Gui-ying(Department of Cardiology,West China Hospital of Sichuan University,Chengdu,Sichuan,610041,China)

机构地区：[1]四川大学华西医院心脏内科,四川成都610041

出　　处：《心血管康复医学杂志》2023年第6期564-569,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:分析高龄人群发生冠心病(CHD)的影响因素及经皮冠状动脉介入治疗(PCI)的疗效。方法:依据是否确诊为CHD,于我院行心脑血管检查的209例高龄患者被分为CHD组(104例)与非CHD组(105例),比较两组一般临床资料。依据治疗方式,冠心病组被分为常规治疗组(接受常规药物治疗)与PCI组,比较两组病情恢复时间、住院时间、住院期间不良事件发生率及随访一年的预后情况。分析高龄人群发生CHD的影响因素。结果:与非CHD组比较,CHD组年龄>80岁、吸烟、糖尿病、高血压、总胆固醇>5.17 mmol/L、甘油三酯>1.7mmol/L、高密度脂蛋白胆固醇(HDL-C)<0.96 mmol/L、低密度脂蛋白胆固醇>3.37 mmol/L、尿酸>420μmol/L、纤维蛋白原>4 g/L比例显著升高(P<0.05或<0.01)。与常规治疗组比较,PCI组病情恢复时间、住院时间、不良事件发生率,随访一年内管腔丢失/再狭窄率、主要和次要终点事件发生率均显著降低(P<0.05或<0.01)。二元Logistic回归分析显示,年龄>80岁、尿酸>420μmol/L、HDL-C<0.96 mmol/L是高龄人群发生CHD的独立危险因素(OR=1.755~6.103,P<0.05或<0.01)。结论:年龄>80岁、尿酸>420μmol/L、HDL-C<0.96 mmol/L是高龄人群发生冠心病的独立危险因素。PCI术能够显著缩短高龄冠心病患者恢复时间和治疗时间,安全性好。Objective:To analyze influencing factors of coronary heart disease(CHD)in advanced aged population and the therapeutic effect of percutaneous coronary intervention(PCI).Methods:According to diagnosed as CHD or not,a total of 209 aged patients underwent cardio-and cerebrovascular examination in our hospital were divided into CHD group(n=104)and no CHD group(n=105),and general clinical data were compared between two groups.According to treatment method,CHD group was divided into routine treatment group(received routine medication)and PCI group;and recovery time,hospital stay,incidence rate of adverse events during admission and prognosis within one-year follow-up were compared between two groups.Influencing factors of CHD in aged population was analyzed.Results:Compared with no CHD group,there were significant rise in percentages of age>80 years,smoking,diabetes mellitus,hypertension,total cholesterol>5.17mmol/L,triglyceride>1.7mmol/L,high density lipoprotein cholesterol(HDL-C)<0.96mmol/L,low density lipoprotein cholesterol>3.37mmol/L,uric acid>420μmol/L and fibrinogen>4 g/L in CHD group(P<0.05 or<0.01).Compared with routine treatment group,there were significant reductions in recovery time,hospital stay,incidence rates of adverse events,lumen loss/restenosis,primary and secondary endpoint events within one-year follow-up in PCI group(P<0.05 or<0.01).Binary Logistic regression analysis indicated that age>80 years,uric acid>420μmol/L and HDL-C<0.96mmol/L were independent risk factors for CHD in advanced aged population(OR=1.755~6.103,P<0.05 or<0.01).Conclusion:Age>80 years,uric acid>420μmol/L and HDL-C<0.96 mmol/L are independent risk factors for coronary heart disease in advanced aged population.PCI can significantly shorten recovery time and treatment time in advanced aged patients with coronary heart disease with good safety.

关 键 词：冠心病 胆固醇 HDL 尿酸 

分 类 号：R541.409[医药卫生—心血管疾病]