高龄冠心病患者行冠状动脉介入治疗的风险及疗效评价

目的:对高龄冠心病患者实施冠状动脉介入治疗风险及疗效进行综合评价。方法:总结分析年龄≥75岁(75～91岁)的高龄冠心病患者98例,<75岁399例,分别分析经皮冠状动脉成形术(PCI)前、术中、术后情况及并发症等。结果:≥75岁组患者术前合并心血管疾病的危险因素种类较<75岁组多〔(4.5±1.75)vs.(2.2±0.68),P<0.05〕,急性冠状动脉综合征(ACS)所占比例,两组之间差异无统计学意义(18.4%vs.20.6%,P>0.05);经桡动脉入路所占比例≥75岁组为56.1%,<75岁组为66.2%,差异无统计学意义;≥75岁组PCI时间长于<75岁组〔(59.1±10.4)m vs.(53.1±11.8)m,P<0.05〕;PCI成功率(96.9%vs.99.7%,P=0.026);术后在院期间病死率、PCI相关并发症发生率,两组差异均无统计学意义,术后在院期间心绞痛再发率,差异无统计学意义(3.1%vs.2%,P>0.05)。结论:高龄冠心病患者中行PCI术,可提高老年患者的生存质量,有明显获益;并且PCI术并发症与手术风险与低年龄组无明显差异,安全性好。

The evaluation of risk and benefits of percutaneous coronary intervention among the aged patients with coronary heart disease

Objective:To evaluate the risk and benefits in aged patients underwent percutaneous coronary intervention(PCI).Methods:The data of 497 patients who underwent PCI were summarized.Among those,98 patients were more than 75 years old and 399 with age less than 75 years.Results:≥75 years group suffered more systemic diseases compared to <75 group((4.5±1.75)vs.(2.2±0.68),P<0.05);the difference of the prevalence of ACS between the two groups was statistically insignificant(18.4% vs.20.6%,P>0.05);The trans-radial approach were applied among 56.1% patients aged more than 75 years while 66.2% in <75 group without significant difference;The elder group had longer duration of process and little lower PCI success rate compared with <75 group((59.1±10.4)m vs.(53.1±11.8)m,P<0.05);(96.9% vs.99.7%,P=0.026).The mortality,prevalence of complication and the recurrence of angina were not found significant difference between the two groups.Conclusion:To perform PCI among the aged patients with coronary heart disease are relatively safe and it can improve the life quality and have apparent benefits.