经皮冠状动脉腔内成形术治疗老年冠心病的近期和远期疗效观察

Acute and long-term efficacy of percutaneous transluminal coronary angioplasty in the elderly

目的 探讨经皮冠状动脉腔内成形术 (PTCA)和支架术治疗老年冠心病患者的近期和远期疗效。方法 连续 2 5 0例冠心病患者 32 1处病变行 PTCA治疗 ,依年龄分为 >6 5岁组 (10 2例 )和≤ 6 5岁组 (14 8例 )。观察手术成功率和住院期并发症。术后每 3～ 4个月定期临床随访 ,如有心肌缺血可疑表现 ,则重复冠脉造影检查 ,如发现再狭窄≥ 70 %则再次进行介入治疗 ,记录再次靶血管重建 (TL R)、总心脏事件和无心脏事件存活率。结果 与≤6 5岁组相比 ,>6 5岁组的女性、糖尿病、高血压病、三支血管病变较多见。两组手术成功率相似 ,分别为 91.2 %和92 .1% (P>0 .0 5 )。随访 6个月两组患者再次靶血管重建 (TL R)、总心脏事件和无心脏事件存活率均相似。结论 经皮冠状动脉腔内成形术 (PTCA)和支架术治疗老年冠心病患者的近期疗效和远期预后良好 ,与年龄无明显关系。

Objective To assess acute and long-term efficacy of percutaneous transluminal coronary angioplasty in the elderly.Methods One hundred and two patients older than 65 and 148 patients not older than 65 underwent coronary arteny stenting.Acute procedural success rate and complication were recorded.Follow-up was carried out every three to four months after the procedure to record cardiac events including cardiac death,myocardial infarction,and target lesion revascularization.Results The patients older than 65 had more female,diabetes mellitus,hypertension,and multi-vessel disease than those not older than 65.Compared with the patients not older than 65,the patients older than 65 had similar acute procedural success rate(92.1% vs 91.2%,P>0.05).In 6-month follow-up,both groups had similar cardiac event and event-free survival rate.Conclusion The efficacy of percutaneous transluminal coronany angioplasty and stenting in the elderly is good,and it is similar to that in younger ones.