摘要
目的探讨老年冠心病患者经皮冠状动脉介入治疗（percutaneous coronary intervention,PCI）术后1 a预后及相关影响因素。方法前瞻性纳入2010年1月—2014年6月在重庆市长寿区人民医院成功行PCI的老年（年龄〉65岁）冠心病患者128例,随访其术后1 a死亡及主要不良心血管事件发生情况,采用COX比例风险回归模型筛选影响老年冠心病患者预后的主要影响因素。结果 PCI术后患者共128例,年龄在65-77岁之间,平均（75.7±6.8）岁;男性患者73例,占57.0%。术后1 a患者随访率为98.4%,术后1 a一级终点事件发生率为9.5%,二级终点事件发生率为11.9%。多因素COX比例风险回归模型分析结果显示,高血压（HR=1.619,95%CI：1.047-2.505,P=0.022）、不稳定型心绞痛（HR=2.905,95%CI：2.222-3.799,P=0.007）是术后1 a不良心血管事件发生风险升高的独立危险因素,而使用β-受体阻滞剂（HR=0.117,95%CI：0.051-0.276,P〈0.01）和使用血管紧张素转酶抑制剂/血管紧张素Ⅱ受体拮抗剂（ACEI/ARB）（HR=0.379,95%CI：0.158-0.911,P=0.003）则是术后1 a不良心血管事件发生风险降低的独立预测因素。结论加强危险因素控制,加强PCI术后充分药物治疗,可在PCI手术基础上改善老年冠心病患者1 a的预后。
[Objective]To analyze the one-year prognosis and related factors in elderly coronary heart disease patients undergoing the percutaneous coronary intervention（PCI）. [Methods]128 elderly coronary heart disease patients over 65 years old,who were successfully treated with PCI in the People＇s Hospital of Changshou District in Chongqing from January 2010 to June 2014,were prospectively included in the study. The objects were followed up for one year to investigate the death and major adverse cardiovascular events. Cox proportional hazard regression model was used to screen the main factors affecting the prognosis of elderly patients with coronary heart disease.[Results]A total of 128 elderly patients with coronary heart disease were investigated,who were aged 65-77 years old with the mean age of（75.7±6.8）years old. There were 73 male cases,accounting for 57.0%. The one year follow-up rate was 98.4%（126/128）,and the incidence rate of primary and secondary endpoint events in the first year after operation was 9.5%（12/126） and 11.9%（15/126） respectively. OX multivariate proportional hazards regression analysis showed that hypertension（HR=1.619,CI 95%： 1.047-2.505,P=0.022）,and unstable angina（HR=2.905,CI 95%： 2.222-3.799,P =0.007） were the independent risk factor for increased risk of adverse cardiovascular events in the first year after operation,while using β-blockers（HR=0.117,CI 95%：0.051-0.276,P〈0.001）and using ACEI/ARB（HR=0.379,CI 95%：0.158-0.911,P=0.003）were the independent predictor of risk reduction.[Conclusion]To strengthen risk factor control and postoperative drug therapy of PCI can improve the prognosis of elderly coronary heart disease patients undergoing PCI.
出处
《职业与健康》
CAS
2016年第11期1581-1584,共4页
Occupation and Health
