介入治疗对老年急性冠状动脉综合征伴缺血性脑卒中患者的临床疗效

Clinical efficacy analysis of interventional in treatment of elderly patients with acute coronary syndrome with ischemic stroke

目的:探讨介入治疗(PCI)对老年急性冠状动脉综合征(ACS)伴缺血性脑卒中患者的临床疗效。方法:选取120例采用介入治疗的老年急性冠状动脉综合征患者为研究对象,根据诊断结果分为两组,每组60例。观察组患者伴缺血性脑卒中,对照组无脑卒中史。对两组患者病例、支架植入数量、血管造影检查结果及不良反应进行观察,并对患者预后的影响因素进行Logistic分析。结果:观察组糖尿病发病率、高血压发病率、肌酐水平、B型钠尿肽水平、肌钙蛋白Ⅰ水平、D-二聚体水平均显著高于对照组,差异有统计学意义(P<0.05);两组冠状动脉病变位置和支架置入数量比较,差异无统计学意义(P>0.05);两组不良反应比较,差异无统计学意义(P>0.05)。logistic回归分析结果显示:患者不良反应的危险因素为肌酐水平、ACS分型,与脑卒中史无关。结论:介入治疗老年急性冠状动脉综合征伴缺血性脑卒中疗效良好,且缺血性脑卒中史对住院期间不良反应的发生无影响。

Objective： To investigate the clinical efficacy of intervention（ PCI） in treatment of elderly patients with acute coronary syndrome（ ACS） with ischemic stroke. Methods： 120 cases of elderly patients with acute coronary syndrome treated by interventional were selected as research subject. Patients were divided into two groups according to the diagnosis results,each group 60 cases. Patients in observation group were with ischemic stroke,and patients in the control group had no history of stroke. The patients basic data,stents implanted number,angiography results,and adverse reactions of two groups were observed. And the prognostic factors were analyzed by Logistic. Results： The diabetes incidence,hypertension incidence,creatinine level,B- type natriuretic peptide level,troponin I level,D- dimer level in observation group were significantly higher than those in control group（ P〈0. 05）. The differences on coronary artery lesion location and stent implantation number of two groups were no statistically significant（ P〉0. 05）. The differences on adverse reactions of two groups were no statistically significant（ P〉0. 05）. Logistic regression analysis results showed that creatinine level and ACS type,not stroke history,were the risk factors of adverse reactions. Conclusion： The intervention is effective for elderly patients with acute coronary syndrome patients with ischemic stroke.