75岁以上老人经皮冠状动脉介入治疗后短期疗效的性别差异

Gender difference in short-term outcome of over-75-year-old patient after percutaneous coronary intervention

目的：研究≥75岁的冠心病患者行经皮冠状动脉介入治疗（PCI）术后住院期间的疗效是否有性别差异。方法从2005年1月到2010年12月502名接受了PCI术的≥75岁老年患者入选本研究，其中36.5%为女性，63.5%为男性。对不同性别患者临床特点和住院期间的疗效进行了比较。结果502名患者年龄为（78.5±3.2）岁，平均住院日（23.2±6.5）d。男性与女性相比，ST段抬高型心肌梗死的发病率高，而心力衰竭的发病率低。男性与女性住院期间的手术成功率（94.3%vs 94.5%， P＝1.000）和死亡率（1.3%vs 3.5%，P＝0.093）差异没有统计学意义。结论在≥75岁的老年冠心病患者中行PCI手术具有高成功率和可接受的死亡率。尽管男性的基础临床情况更差一些，但在接受PCI术的老年患者中，住院期间的结果没有性别差异。

Objective To investigate whether there exists difference in in-hospital outcomes between male and female elderly patients with coronary artery diseases after percutaneous coronary intervention （PCI）. Methods In a single center, a total of 502 consecutive patients （aged ≥75 years, 36.5% women and 63.5% men） who underwent PCI from January 2005 to December 2010 were recruited in this cohort study. Clinical features and in-hospital outcomes were compared between males and females. Results The age of the 502 patients was （78.5±3.2） years. The in-hospital length was （23.2±6.5）d. The male patients presented higher prevalence of ST elevation myocardial infarction but lower incidence of heart failure than the female ones. There was no significant difference in the successful rate of in-hospital procedures （94.3% vs 94.5%, P=1.000） and in mortality （1.3% vs 3.3%, P=0.093） between the male and female patients. Conclusion For the patients over 75 years old with coronary artery diseases, PCI is a good choice with higher successful rate and acceptable mortality. Although males have worse baseline conditions, there is no difference in in-hospital outcome between males and females after PCI.