老年冠心病患者经皮冠状动脉介入治疗分析

Characteristics of percutaneous coronary intervention for elderly patients with coronary heart disease

目的探讨老年与非老年冠心病患者择期经皮冠状动脉介入治疗(PCI)的特点。方法 217例冠心病患者,依年龄分为老年组(>65岁)72例和非老年组(≤65岁)145例,冠状动脉造影(CAG)显示404处病变,相应接受了245次PCI治疗,其中有153例患者成功植入冠状动脉支架172枚,记录术中并发症以及术后住院期间主要不良心脏事件(MACE)发生情况,结合病史分析两组特点及区别。结果老年组女性患者比例、高血压、糖尿病、不稳定型心绞痛发生率、多支病变率、手术并发症发生率、支架植入率均高于非老年组;但老年组吸烟率、合并高脂血症及单支病变率均低于非老年组;两组患者重度血管狭窄(狭窄≥90%)率及手术成功率相似(P>0.05)。结论老年组与非老年组相比,PCI的手术成功率差异无统计学意义,但老年组手术并发症以及手术后MACE发生率高于非老年组,因此,对老年患者行PCI治疗前应权衡利弊。

Objective To evaluate the characteristics of percutaneous coronary intervention（PCI） in elderly and middle age patients with coronary heart disease（CHD）.Methods Two hundreds and seventeen patients with CHD were divided into two groups（elderly and middle age） according to the age.A total of 404 coronary artery lesions were discovered by coronary arteriography（CAG） and 245 lesions were successfully treated by PCI.172 stents were implanted in 153 cases.The procedural complications,in-hospital major adverse cardiac events（MACE） and clinical characteristics were recorded in all of the patients.Results The ratios of female,hypertension,diabetes,unstable angina,multi-vessel lesions,procedural complications,stent implantation in elderly patients in elderly patients were higher than those of middle age patients（P0.05）.The ratios of smoking,hyperlipidemia,mono-vessel lesion were lower in elderly patients than those of middle age patients（P0.05）.Severe pre-procedural stenosis（≥90%） and procedural success rate were not significantly different between two groups（P0.05）.Conclusion There is no significant difference between elderly patients and middle age patients in the procedural success rate.The ratios of procedural complications and MACE in elderly patients were higher than those of middle age patients,so it is prudent in dealing with PCI in elderly.