摘要
目的评估年龄≥85岁PCI患者手术安全性及死亡风险。方法选择2013年1月~2017年5月在海军总医院心内科住院行PCI且年龄≥85岁的冠心病患者90例,记录手术入路,术前与术后估算肾小球滤过率及出血事件,冠心病危险评分体系美国国家心血管注册研究(National Cardiovascular Date Registry,NCDR)风险评分评估30d及随访期死亡风险,平均随访(693±510)d。结果 90例患者中,以桡动脉入路成功行PCI术84例(93.3%),造影剂用量(128.3±55.8)ml。术前与术后肾小球滤过率比较,差异无统计学意义[(55.53±19.58)ml/(min·1.73m^2)vs(55.40±18.84)ml/(min·1.73m^2),t=0.095,P=0.925]。4例(4.4%)患者发生出血事件,无累及生命的大出血。NCDR风险评分>45分患者PCI 30d死亡风险增加(P=0.013)。结论年龄≥85岁患者进行PCI安全可行,NCDR风险评分能够预测患者30d死亡风险。
objective To assess the safety of PCI and risk of death in≥85 years old patients.Methods Ninety ≥85 years old coronary heart disease patients after PCI were included in this study.The risk of death on day 30 after PCI and during the follow-up period was assessed according to their surgical access,preoperative and postoperative estimated glomerular filtration rate(eGFR)and bleeding events,NCDR risk score of CHD.The patients were followed up for 693±510 days.Results Eighty-four patients(93.3%)underwent PCI via the radial artery.The dose of contrast media was 128.3±55.8 ml.No significant difference was found in preoperative and postoperative eGFR(55.53±19.58 ml/min·1.73 m^2 vs 55.40±18.84 ml/min·1.73 m^2,t=0.095,P=0.925).Bleeding occurred in 4 patients(4.4%)with no life-threatening massive bleeding occurred.The risk of death increased in patients with their NCDR risk score 45 on day 30 after PCI(P=0.013).Conclusion PCI is a safe and feasible procedure and NCDR risk score can predict the risk of death in ≥85 years old patients on day 30 after PCI.
作者
王志超
徐争鸣
姚晶
陈宇
裘毅钢
曹毅
李田昌
Wang Zhichao, Xu Zhengming, Yao Jing, Chen Yu, Qiu Yigang, Cao Yi, Li Tianchang(Department of Cardiology, Chinese PLA Navy General Hospital, Beijing 100048, Chin)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2018年第3期257-259,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
肾小球滤过率
冠心病
桡动脉
造影剂
出血
预测
glomerular filtration rate
coronary disease
radial artery
contrast media
hemorrhageforecasting