老年退行性心瓣膜病合并冠心病患者的疗效观察

Clinical observation of effect in treatment of senile degenerated heart valvular disease and coronary heart disease

目的:探讨老年退行性心瓣膜病合并冠心病患者的临床特点。方法:将58例通过临床症状、心电图、X线、冠状动脉造影和超声心动图检查确诊的老年退行性心瓣膜病合并冠心病患者作为观察组(SDHVD+CHD),选择同期冠心病患者58例作为对照组(CHD)。并对两组的年龄、心功能、冠脉血管病变、脂代谢异常、心力衰竭、心律失常及纤维蛋白原(FIB)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)进行比较。结果:随着年龄的增加,重度SDHVD检出率增加;年龄、TC、LDL-C、HDL-C、FIB、血脂异常、心力衰竭、心律失常在组间分布差异均有统计学意义(P<0.01、P<0.05)。结论:SDHVD随年龄增加而病情加重,TC、LDL-C、HDL-C、FIB明显增高,冠脉病变总支数、钙化或弥漫性病变明显增多,易导致心律失常和心力衰竭,应重视SDHVD的预防和治疗。

Objective：To discuss the clinical features of degenerative valvular heart disease with coronary heart disease in patients.Methods：58 cases were checked by clinical symptoms,ECG,X ray,coronary angiography and echocardiography confirmed,and be sure for degenerative heart valvular disease with coronary heart disease in patients as the observation group（SDHVD＋CHD）,in the same period 58 patients with CHD as a control group（CHD）.Their age,cardiac function,coronary vascular disease,lipid metabolic disorders,heart failure,arrhythmia,fibrinogen（FIB）,total cholesterol（TC）,high density lipoprotein cholesterol（HDL-C）,low density lipid protein cholesterol（LDL-C） and triglycerides（TG） were compared.Results：With the age increasing,the detection rate of severe SDHVD was increasing,too;the age,TC,LDL-C,HDL-C,FIB,dyslipidemia,heart failure,arrhythmia in distribution between two groups were statistically significant（P〈0.01,P〈0.05）.Conclusion：SDHVD aggravates with age increasing,TC,LDL-C,HDL-C,FIB are significantly higher,the number of coronary artery disease aggregate expenditure,calcification or diffuse lesions increase significantly which could result in arrhythmia and heart failure,should pay attention to SDHVD of prevention and treatment.