老年左冠状动脉主干狭窄的临床特点

Clinical features of left main stenosis in the elderly patients

目的探讨老年患者左冠状动脉主干狭窄的临床表现、诊断、治疗及预后特殊性。方法年龄≥６０岁，经冠状动脉造影证实左主干狭窄患者２４例，男２３例，女１例，平均年龄６２２岁。据冠脉造影左主干狭窄程度分为轻度、中度、重度及极重度。结果①老年患者左冠状动脉主干狭窄的发生率（１１％）略高于普通人群。②所有患者（１００％）合并有１种或多种危险因素。③所有患者均表现为不稳定型心绞痛（１００％）。④所有患者左冠脉主干狭窄均合并有其他血管的病变，并且以合并多支血管病变为主（８７％）。且左冠状动脉主干狭窄多位于左主干分叉处（９１７％）。⑤左室射血分数平均为４９５％。结论老年左冠状动脉主干狭窄发生率略高，多合并有其他血管病变及更多危险因素，临床症状更严重。

In this study,there are 24 patients with the age over 60 years old,23 males and 1 female.The average age is 66 2 years old.According to the coronary angiography ,the stenosis of left main could be divided into four groups,slight,mild,severe and extremely severe. Results In this study,①The incidence of left main stenosis in the elderly is a little higher(11%).②All of the patients(100%)with left main stenosis have one or more risk factors,unstable angina,and combine with other vessel stenosis.③Most of the lesions (91.7%)locate at the bifurcation of the left main.④The average left ventricular ejection fraction is 49.5%. Conclusions The incidence of left main stenosis is a little higher in the elderly.The aged patients with left main stenosis have more risk factors,much severe symptoms,worse prognosis and often combine with other vessel stenosis.