高龄冠心病患者经股动脉与桡动脉途径穿刺介入术治疗的效果、安全性、心肌纤维化和左心功能评估

Efficacy,Safety,Myocardial Fibrosis and Left Ventricular Function in Elderly Patients with Coronary Heart Disease Undergoing Percutaneous Coronary Intervention via Femoral Artery and Radial Artery

目的对比经股动脉与桡动脉途径穿刺介入术治疗高龄冠心病的疗效、安全性及心肌纤维化和左心功能。方法选取我院2015年4月-2017年4月收治的80例高龄冠心病患者,依据治疗方法分为经股动脉途径穿刺介入术组(股动脉组)和经桡动脉途径穿刺介入术组(桡动脉组),各40例。对比两组患者的临床疗效、术中术后指标、并发症发生情况及心肌纤维化和左心功能。结果两组患者的手术成功率无统计学差异(P>0.05);桡动脉组患者的穿刺时间显著长于股动脉组(P<0.05),术后卧床时间、住院时间均显著短于股动脉组(P<0.05),术后并发症发生率显著低于股动脉组(P<0.05)。术前与术后两组间血清PCⅠ、PCⅢ、LN及HA水平均无统计学差异(P>0.05);各组术后与术前比较均明显降低(P<0.05)。术前与术后两组间BNP、LVEDs、LVEDd、LVEF及FS均无统计学差异(P>0.05);各组术后与术前比较BNP、LVEDs及LVEDd均降低(P<0.05),LVEF及FS均增大(P<0.05)。结论经股动脉与桡动脉途径穿刺介入术治疗高龄冠心病的疗效、安全性及对心肌纤维化和左心功能改善程度相当,但后者的恢复时间更短,并发症较少。

Objective To explore the efficacy, safety, myocardial fibrosis and left ventricular function in elderly patients with coronary heart disease undergoing percutaneous coronary intervention via the femoral artery and radial artery. Methods A to-tal of 80 cases of elderly patients with coronary heart disease treated in our hospital between April 2015 and April 2017 were se-lected and divided into the femoral artery puncture intervention group （ femoral artery group, n=40 ） and the transradial artery puncture intervention group （radial artery group, n=40）. The clinical efficacy, intraoperative and postoperative indexes, com-plications, myocardial fibrosis and left ventricular function were compared between the two groups. Results There was no statisti-cally significant difference in the success rate of the two groups （P〉0. 05）. Puncture took a significantly longer time in the radial artery group than in the femoral artery group （P〈0. 05）. The duration of bed rest and hospitalization was significantly shorter than that of the femoral artery group （P〈0. 05）. The incidence of postoperative complications was significantly lower than that of the femoral artery group （P〈0. 05）. There was no significant difference in serum PC I, PC III, LN and HA between the two groups before and after operation （P〉0. 05）. There was also no significant difference in BNP, LVEDs, LVEDd, LVEF and FS between the two groups before and after the operation （P〉0. 05）, but the levels of BNP, LVEDs and LVEDd of the two groups decreased after operation （P〈0. 05）, while LVEF and FS increased （P〈0. 05）. Conclusion The therapeutic effect, levels of safety and improvement of myocardial fibrosis and left heart function during the treatment of elderly coronary heart disease through femoral artery and radial artery puncture intervention are similar, but the latter requires a shorter recovery time and causes fewer complications.