摘要
目的旋磨术联合药物洗脱支架（DES）治疗老年冠状动脉钙化病变的安全性及有效性研究。方法回顾性分析在解放军总医院行冠状动脉旋磨术联合药物洗脱支架治疗的老年冠心病钙化病变患者143例。分析术中技术特点，术前术后造影和血管内超声资料、术中即刻并发症及患者院内和术后1年累积主要不良心脑血管事件（MACCE）发生率及影响因素。结果旋磨术联合DES治疗老年冠状动脉钙化病变手术成功率为97．2％，随访1年累积MACCE发生率为13．3％，左主干病变（HR：7．249，95％CI：1．501-35．459，P=0．014）、非计划性旋磨（HR：9．466，95％CI：2．219～40，375，P=0．002）、LVEF〉40％（HR：0．064，95％CI：0．0t1～0．385，P=0．003）、球囊后扩张（HR：0．232，95％CI：0．069～0．785，P=0．019）、支架后狭窄面积（HR：0．538，95％CJ：0．374～0．774，P=0．001）。与支架置入前比较，支架置入术后狭窄直径显著增大，直径狭窄率显著减小，差异有统计学意义（P=0．000）。结论旋磨联合DES治疗老年冠状动脉钙化病变手术成功率高，长期随访临床效果较好。
Objective To study the safety and efficacy of rotational atherectomy （RA） combined with drug-eluting stenting （DES） in elderly patients with coronary calcified lesions. Methods One hundred and forty-three elderly patients with coronary calcified lesions who underwent RA combined with DES in our hospital were included in this study. Their clinical data, surgical characteristics, angiographic and ultrasonic data before and after operation, intra-operative complications, MACCE and their influencing factors were retrospectively analyzed. Results The success rate of RA combined with DES was 97.2 %in elderly patients with coronary calcified lesions. The incidence of MACCE in 1-year follow-up was 13.3%. Left main branch lesion,unexpected RA,LVEF〉 40% ,saccular posterior dilatation and minimum stent lumen area were the major influencing factors of MACCE （HR=7. 249,95%CI. 1. 501-35. 459,P=0. 014;HR=9. 466,95 %CI. 2. 219- 40. 375,P=0. 002;HR=0. 064,95%CI.0. 011-0. 385,P=0. 003;HR=0. 232,95%CI：0. 069% 0. 785,P=0. 019;HR=0. 538,95%CI：0. 374-0. 774,P=0. 001）. The minimum diameter stenosis was significantly larger while the minimum diameter stenosis rate was significantly lower after DES than before DES. Conclusion The success rate of RA combined with DES is high in elderly patients with coronary calcified lesions and their long-term clinical follow-up outcomes are good.
出处
《中华老年心脑血管病杂志》
CAS
2016年第3期247-250,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
首都市民健康项目(Z13110200400000)
