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老年支架内慢性完全闭塞介入治疗的疗效及安全性(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2008年第3期
页码:
316-319
栏目:
临床研究
出版日期:
2008-05-20

文章信息/Info

Title:
Efficacy and safety of coronary intervention treatment in elderly patients with instent chronic total occlusions
作者:
孙鸣宇1; 韩雅玲2; 张剑2; 荆全民2; 王守力2
1.第四军医大学西京医院心内科，陕西 西安 710032； 2.沈阳军区总医院心内科 全军心血管病研究所，辽宁 沈阳 110016
Author(s):
SUN Mingyu1;  HAN Yaling2;  ZHANG Jian2;  JING Quanmin2;  WANG Shouli2
1.Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China; 2.Department of Cardiology, PLA Shenyang General Hospital, PLA Cardiovascular Research Institute, Shenyang 110016, Liaoning, China
关键词:
冠状动脉疾病; 慢性完全闭塞; 支架; 再狭窄; 血管成形术; 经腔; 经皮冠状动脉
Keywords:
coronary disease;  chronic total occlusion;  stent;  restenosis;  angioplasty;  transluminal;  percutaneous coronary
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 探讨老年患者冠状动脉支架内慢性完全闭塞(ISCTO)病变经皮冠状动脉介入治疗(PCI)的疗效及安全性。方法 2000年5月～2007年6月入院复查造影发现有ISCTO病变的51例老年患者（年龄≥65岁）及84例非老年患者（年龄＜65岁）行再次PCI治疗。对两组患者的临床资料、PCI结果以及围术期并发症和随访期间主要不良心脑血管事件(MACCE)发生率进行回顾性分析。结果 老年组高血压比例及表现为无症状心肌缺血和心力衰竭的比例高于非老年组（均P<005）。老年组ISCTO中绝对性闭塞、刀切状病变、长度≥15 mm、直径≤25 mm、病变处弯曲≥45°或有分支发出的病变比例均高于非老年组（均P<005）。两组病变成功率和病例成功率无统计学差异（94% vs 93%，96% vs 93%）。两组术中无死亡病例，术后住院期间无不良心脏事件发生，无患者进行急诊冠状动脉旁路移植术（CABG）。老年组和非老年组分别随访（17±15）个月和（16±15）个月，老年组心绞痛复发率低于非老年组（P<005），两组MACCE发生率无统计学差异。结论 对老年患者的ISCTO病变行介入治疗是安全而有效的。
Abstract:
AIM To discuss the efficacy and safety of percutaneous coronary intervention (PCI) treatment in elderly patients with instent chronic total occlusion (ISCTO). METHODS Clinical data, outcomes of PCI, perioperative complications and incidence of major adverse cardiac and cerebral events (MACCE) during followup were retrospectively analyzed and compared between elder group (≥65 years, n=51) and younger group(<65 years, n=84) with ISCTO between May 2000 and June 2007. RESULTS The proportions of patients with hypertension, silent myocardial ischemia and heart failure were higher in elder group than that in younger group（P<005）. The ratios of ISCTO characterized with absolute occlusion and stump missing, ≥15 mm in length, ≤25 mm in diameter, ≥45° tortuosity of proximal segment and bifurcation were all higher in elder group than those in younger group（P<005）. No statistical difference was seen in the success rates of lesions and patients between the two groups（94% vs 93%，96% vs 93%）. No death occurred during operation, no major adverse coronary events (MACE) occurred after operation in hospital and no patient undertook emergency coronary artery bypass grafting (CABG) in both groups. The followup periods were (17±15) months and (16±15）months in elder group and younger group respectively. The angina recurred less frequently in elder group（P<005）. The incidence of MACCE had no difference in the two groups. CONCLUSION It is safe and effective to treat the elderly patients with ISCTO interventionally.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2007-09-03.作者简介：孙鸣宇，硕士生Email:sunmingyu1976@126.com
更新日期/Last Update: