摘要
目的:评价80岁以上老年冠心病患者接受介入治疗的疗效及安全性。方法:回顾性分析2004-01至2008-12在我院接受介入治疗的≥80岁的冠心病患者172例,记录住院期间临床及介入资料,并进行电话或门诊随访。结果:172例冠心病患者中,30例为稳定性心绞痛患者,75例为不稳定性心绞痛患者,51例急性ST段抬高型心肌梗死,16例急性非ST段抬高型心肌梗死;平均年龄为(82.3±2.5)岁。手术成功率为94.8%。住院期间心源性死亡率为4.1%,消化道出血发生率为4.7%;长期随访心源性死亡率为4.9%,二次血运重建率为8.0%,消化道出血发生率为1.9%,脑出血发生率为1.2%。单因素分析女性、急性心肌梗死、左心室射血分数(LVEF)及陈旧脑梗塞与心源性死亡相关(OR=3.925、5.658、0.898、5.098,95%CI分别为3.352～4.498、4.533～5.663、0.863～0.933、5.081～6.235,P均<0.05),多因素分析LVEF及陈旧脑梗塞是心源性死亡的独立预测因子(OR=0.911、7.868,95%CI分别为0.868～0.954、7.126～8.610,P均<0.05)。结论:80岁以上冠心病患者接受冠脉介入治疗及双重抗血小板治疗相对安全、有效。
Objective ：To asses the effect and safety of percutaneous coronary intervention （PCI） in patients with coronary artery disease （CAD） at the age of 80 years or elder. Methods ： A total of 172 consecutive patients with the mean age of （ 82. 3 ＋ 2. 5 ） years who underwent PCI between January 2004 and December 2008 in our hospital were summarized. The patients＇ information of in-hospital condition and PCI procedure were recorded and ana- lyzed. 94. 2% （162/172）of patients were followed-up for the average of （34 ＋ 17 ）months by either clinical examination or telephone visit. Results：Among all the patients, 30 of them were admitted with stable angina pectoris ,75 with unstable angina pectoris and 67 with acute myocardial infarction（AMI）. The PCI success rale was 94. 8%. The in-hospital cardiac death was 4. 1% and the in-hospital gastrointestinal haemorrhage was 4. 7%. While during the follow-up period of time ,the cardiac death was 4. 9% ,the gastrointestinal haemorrhage was 1.9% , and the cerebral haemorrhage was 1.2%. The occurrence of revascularization was 8.0%. Univariate analysis revealed that female, AMI, left ventricular ejection fraction （LYEF） and the history of stroke were correlated with the cardiac death（ OR = 3. 925,5. 658,0. 898,5. 098, 95% CI = 3. 352 - 4. 498,4. 533 - 5. 663,0. 863 - 0. 933,5. 081 - 6. 235 ,P 〈 0. 05, respectively）. Multivariate analysis indicated that LVEF and the history of stroke were the independent predictors for the cardiac death （OR = 0. 911,7. 868,95% CI = 0. 868 - 0. 954,7. 126 - 8.610, P 〈 0. 05, respectively）. Conclusion：PCI was relatively effective and safe in patients with CAD at the age of 80 years or elder.
出处
《中国循环杂志》
CSCD
北大核心
2010年第4期251-254,共4页
Chinese Circulation Journal
关键词
老年
经皮冠状动脉介入治疗术
预后
Octogenarian
Percutaneus coronary intervention
Prognosis
