两种方法治疗高龄急性冠状动脉综合征的预后比较

Prognosis comparison of advanced age patients with acute coronary syndrome two years after treatment

目的：比较高龄（年龄≥75岁）急性冠状动脉综合征（ACS）患者行经皮冠状动脉介入（PCI）治疗与保守治疗后24个月的预后情况。方法134例高龄ACS住院患者依治疗方法不同分为观察组及对照组，观察组71例以标准方法行PCI治疗，对照组63例为药物保守治疗。比较两组患者临床资料及出院后24个月心血管事件及心源性死亡发生率。结果观察组住院期间死亡2例，病死率2．82％（2/71）；随访24个月心血管事件发生率16．90％（12/71），心源性死亡发生率5．63％（4/71）。对照组住院期间3例死亡，病死率4．76％（3/63）；随访24个月心血管事件发生率36．51％（23/63），心源性死亡发生率11．11％（7/63）。两组患者住院期间病死率差异无统计学意义（χ2＝0．352，P＝0．553）；出院24个月心血管事件及心源性死亡发生率观察组明显低于对照组，差异有统计学意义（χ2＝6．650，P＝0．010）。结论高龄ACS患者行PCI治疗可降低心肌梗死风险及病死率，明显改善症状，有效降低患者24个月心血管事件及心源性死亡发生率。

Objective To discuss prognosis and relevant factors of the advanced age patients （ over 75 years old） with acute coronary syndrome two years after treated by percutaneous coronary intervene （ PCI ） and conservative treatment .Methods divided 134 cases of advanced age inpatients with acute coronary syndrome were into the obser -vation group and control group in accordance with the different therapies .To 71 inpatients in the observation group treated with standard PCI therapies and treated 63 inpatients in the control group with conservative treatment .Compare the clinical data and their cardiovascular event occurrence rate , case fatality rate and influencing factor of the two groups two years after they left the hospital .Results During the hospitalization ,there were 2 patients in the observa-tion group died,the case fatality rate was 2.82%（2/71）,during 24 months follow-up visit,the cardiovascular event occurrence rate was 16.90%（12/71）,and cardiac mortality was 5.63%（4/71）.Well,in control group,there were 3 patients died,the case fatality rate was 4.76%（3/63）,during 24 months follow-up visit,the cardiovascular event occurrence rate was 36.51%（23/63）,and cardiac mortality was 11.11%（7/63）.The fatality rate of the two groups during the hospitalization had no significant difference （χ2 =0.352,P=0.553）,the cardiovascular event occurrence rate and cardiac mortality of the patients in the observation group was superior to that of the control group 24 months after they left hospital,the difference between the two groups was significant （χ2 =6.650,P=0.010）.Conclusion PCI treatment to advanced age patients with ACS could reduce their myocardial infarction risk and case fatality rate and improve the symptom obviously ,effectively reduce the patients ’ cardiovascular event and cardiac death occurrence rate in two years .