老年左心室功能不全患者行冠状动脉内支架术  

Elective coronary stenting in elderly patients with left ventricular dysfunction

作　　者：蒋利[1] 沈卫峰[1] 张建盛[1] 张瑞岩[1] 吕安康[1] 胡健[1] 

机构地区：[1]上海第二医科大学附属瑞金医院心脏科,上海200025

出　　处：《中华老年心脑血管病杂志》2003年第1期9-11,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的　评价左心室功能不全对老年冠心病患者选择性冠状动脉内支架术安全性和远期预后的影响。方法　4 76例老年冠心病患者行选择性冠状动脉内支架术 ,其中 73例左心室射血分数 <4 0 % (左心室功能不全组 ) ,4 0 3例左心室射血分数≥ 4 0 % (对照组 )。分析两组患者手术结果和远期预后。结果　两组支架术成功率 (95 .8%和95 .9% )和手术并发症相似 (2 .2 %和 2 .7% ,P >0 .0 5 )。在 (16± 8.4 )个月随访期中 ,左心室功能不全组死亡率较对照组显著增高 (14 .1%和 3.2 % ,P =0 .0 0 1)。多因素分析显示 ,左心室射血分数是老年患者冠状动脉内支架术后远期死亡的独立预测因素 (RR 0 .95 0 ,95 %CI0 .919～ 0 .981,P =0 .0 0 2 )。结论　左心室功能不全的老年冠心病患者选择性冠状动脉内支架术安全 。Objective To evaluate the influence of left ventricular dysfunction on initial and long term outcomes after coronary stenting in elderly patients with coronary artery disease.Methods Four hundred and seventy six patients aged ≥60 years old with coronary artery disease who underwent elective coronary stenting were divided into two groups: left ventricular dysfunction group[73 patients with left ventricular ejection fraction(LVEF) <40%] and control group(403 patients with LVEF ≥40%). The initial results and long term follow up outcomes were analyzed.Results Procedural success rate(95.8% vs 95.9%) and complication( 2.2 % vs 2.7%) were similar between the two groups(both P>0.05). Mean follow up period was 16± 8.4 months. Late mortality was higher in the left ventricular dysfunction group than in the control group( 14.1 % vs 3.2%, P=0.001). Multivariate analysis showed that LVEF was an independent predictor of late mortality (relative risk 0.950,95%CI 0.919～0.981,P=0.002).Conclusion Eelective coronary stenting in elderly patients with left ventricular dysfunction is safe, but the late mortality remains relatively high.

关 键 词：老年人 左心室功能不全 冠状动脉内支架术 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病] R815[医药卫生—内科学]