摘要
目的高龄不稳定心绞痛(unstable angina,UA)患者的治疗较为复杂,比较不完全介入性冠状动脉血运重建与单纯药物治疗对75岁以上高龄UA患者的长期疗效。方法对2004年2月至2007年8月行不完全介入性血运重建的46例UA患者不完全介入性血运重建组及同期单纯药物治疗的44例UA患者单纯药物治疗组进行随访观察。结果不完全介入性血运重建组和单纯药物治疗组的随访时间分别为(32.6±5.8)个月和(32.4±5.6)个月,2组月均心绞痛发作的次数、发生心肌梗死的人数以及因上述心脏病死亡的人数均无显著差异。不完全介入性血运重建组因心绞痛住院人均(3.6±2.0)次,多于单纯药物治疗组的(2.8±1.7)次(P<0.05);在随访期行介入血运重建或冠状动脉搭桥的例数分别为4和1,单纯药物治疗组分别为1和5(P>0.05);不完全介入性血运重建组和单纯药物治疗组发生急性左心衰竭的例数分别为2和6(P>0.05)。结论对75岁以上的高龄UA患者,冠状动脉不完全介入性血运重建的长期疗效尚不能认为优于单纯药物治疗。
Objective The treatment of unstable angina （UA） in aged patients is complicated. The aim of this study was to compare long-term clinical efficacy of incomplete interventional revascularization （ Ⅱ R） and pure standardized medication （PSM） on UA in patients above 75 years old. Methods We included in this study 46 UA patients treated by Ⅱ R and another 44 by PSM from February 2004 to August 2007. All the patients were males and aged above 75 years. The clinical efficacy of the treatments and the conditions of the patients were followed during their hospital stay and by monthly visit and telephone exchange. Results The patients of the Ⅱ R and PSM groups were followed up for （ 32.6 ± 5.8 ） and （32.4 ±5.6 ） months, respectively, which revealed no statistical differences in monthly angina peetoris frequency, the number of acute myocardial infarction attacks and the number of deaths from heart diseases. The per-person number of hospitalizations for angina peetoris were （ 3.6± 2.0） in the Ⅱ R and （2.8± 1.7 ） in the PSM group （ P 〈 0.05 ）. Four cases received interventional revascularization and 1 underwent coronary artery bypass grafting （CABG） during the follow-up in the former group, as compared with 1 and 5 cases in the latter （P 〉 0.05）. Two cases developed acute left cardiac failure in the II R and 6 in the PSM group （ P 〉 0.05 ）. Conclusion Incomplete interventional revascularization can not be considered superior to pure standardized medication for UA in patients older than 75 years.
出处
《医学研究生学报》
CAS
2010年第2期178-180,共3页
Journal of Medical Postgraduates
关键词
不稳定心绞痛
血运重建
高龄
Unstable angina
Revascularization
Advanced age
