老年不稳定性心绞痛择期冠状动脉介入治疗与强化药物治疗的对比研究

目的通过对老年不稳定性心绞痛的冠心病患者经择期PCI和单纯优化药物治疗住院期间及治疗后近期心血管事件比较,探讨老年不稳定性心绞痛的治疗选择。方法随机选择老年不稳定性心绞痛患者268例,根据是否行介入治疗分为:介入组134例(发病后3～7d接受择期PCI)和药物组134例(未行PCI术,单纯优化药物治疗),分别比较住院10d、出院30、90d后2组主要不良心脏事件及左心室功能。结果出院30、90d随访2组主要不良心脏事件,差异无统计学意义(P>0.05)。介入组再发心绞痛及左心室功能较药物组明显改善(P<0.05),介入组住院期间发生出血事件明显高于药物组(P<0.05)。结论对于老年不稳定性心绞痛行择期PCI有利于左心室功能的改善和抑制左心室重构,择期PCI治疗老年不稳定性心绞痛患者是可行的。

Effect of PCI and reinforcement drug treatment on outcome in elderly coronary heart disease patients with unstable angina

Objective To study the treatment modalities for elderly coronary heart disease(CHD) patients with unstable angina(UA) by comparing the short-term cardiovascular events after percutaneous coronary intervention(PCI) and simple optimal drug therapy.Methods Two hundred and fifty-four CHD patients with UA were randomly divided into PCI group(n=134) and optimal drug treatment group(n=134).Patients in PCI group underwent PCI 3-7 days after the onset of UA and those in optimal drug therapy group received simple optimal drug treatment.The major adverse cardiac events and left ventricular function were compared between the two groups 10 days after admission and 30 and 90 days after discharge.Results No significant difference was found in the major adverse cardiac events between the two groups during the 30 and 90 days follow-up periods after discharge(P>0.05).The left ventricular function was significantly better and the recurrent angina rate was significantly lower in PCI group than in optimal drug treatment group(P<0.05).The incidence of in hospital bleeding events was significantly higher in PCI group than in optimal drug treatment group(P<0.05).Conclusion PCI can improve the left ventricular function,inhibit the left ventricular remodeling in elderly CHD patients with UA and can thus be used in treatment of CHD patients with UA.