老年冠心病患者PTCA疗效的临床评价

CLINICAL EFFICACY OF PTCA WITH CORONARY ARTERY DISEASE IN ELDERLY PATIENTS

目的评估年龄≥ 60岁冠心病患者 PTCA的疗效和安全性。方法本文回顾性分析 1997年 4月至 1999年 3月 427例 PTCA患者，其中甲组 (≥ 60岁 )284例和乙组 (<60岁 )143例。记录术前临床特点和冠状动脉造影发现，手术成功标准为：残余狭窄 <30％， TIMI血流 3级及无严重并发症。结果与乙组比较，甲组女性比例显著增多 (28.5％比 11.7％， P<0.05)，不稳定性心绞痛 (P<0.05)和多支病变 (P<0.005)增多。两组 PTCA手术成功率无显著性差异。甲组 15例和乙组 2例手术失败，除甲组 1例术后残余狭窄 >30％外，其余均因导引钢丝不能通过慢性冠状动脉完全阻塞病变所致。结论年龄≥ 60岁冠心病患者 PTCA的临床成功率和并发症与年轻患者相似。

Objective This study was performed to evaluate the efficacy and safety of PTCA with coronary artery disease in elderly patients.Methods 427 patients who underwent PTCA between April 1997 and March 1999 were retrospectively analyzed.284 patients were 60 years or older of age (group A),143 patients were under 60 years of age (group B). Clinical characteristics and angiographic findings were recorded.Procedural success was difined as residual stenosis<30％ ,TIMI 3 flow and without major complications.Results Female gender was more common in group A than in group B (28.5％ vs 11.7％ ,p<0.05) and patients in group A had a higher incidence of unstable angina and multivessel disease than those in group B.The procedural success was similar in the two groups.PTCAwas failed in 15 patients in group A and 2 patients in group B.This was due to impossibility of guidewire to cross over chronic total obstructive lesion in 16 patients and residual stenosis of >30％ in one patient in group A. All patients had no major complications during the procedure.Conclusions The procedural success rate of PTCA was similar in elderly patients compared with young patients,indicating that percutaneous coronary intervention is safe and effective even for elderly patients.