不同血运重建策略对75岁以上女性缺血性心力衰竭患者的预后分析

The effect of different reascularization treatment on above 75-year-old female patient with ischemic heart failure in prognosis

目的:探究血运重建策略对年龄大于75岁的女性缺血性心力衰竭患者预后的影响。方法:选择我院年龄大于75岁女性缺血性心力衰竭患者,根据是否完全血运重建,分为部分血运重建组(partial revascularization group,PR组)与完全血运重建组(completely revascularization group,CR组)。分别于3个月、12个月返院行心脏彩超检查,对比两组患者病死率、左室射血分数,评价不同血运重建策略对年龄大于75岁的女性缺血性心力衰竭患者的疗效。结果:PR组27例,CR组40例,两组基线资料无统计学差异。3个月后,两组患者左室射血分数均得到有效的改善(PR∶CR为39.6%∶48.4%),P=0.004;一级不良事件无统计学差异,P=0.377;不良事件率无统计学差异(40.7%∶25.0%),P=0.287。随访至12个月,左室射血分数改善(PR∶CR为41.8%∶48.1%),P=0.008;一级不良事件无统计学差异,P=0.276;两组患者事件率无统计学差异(63.0%∶37.5%),P=0.082。结论:老年女性缺血性心力衰竭患者经积极完全血运重建能改善心脏功能,不能改善事件率,亦未能带来生存获益。

Objective：To test the efficacy of different revascularization strategy for age more than 75-year-old female patients with ischemic heart failure on the early prognosis.Method：Our candidates are the age greater than75-year-old female patients with ischemic heart failure in our hospital.All patients are arranged into partial revascularization group（PR）and completely revascularization group（CR）according to the different strategies.Followed up for 3 th month and 12 th month,the mortality and hospital readmission rate,left ventricular ejection function（LVEF）,were collected.Result：After 3 months,the LVEF improvement was significant differences（39.6%VS 48.4%）,P=0.004.There were no significant differences between PR group and CR group in the event rate and primary end point.After 12 months,there were no significant differences between PR group and CR group in the event rate and primary end point.Conclusion：The positive completely revascularization can improve the LVEF in elderly female patient with ischemic heart failure,but fail to bring longtime survival benefits.