介入治疗与药物治疗老年不稳定型心绞痛疗效比较

目的探讨老年不稳定型心绞痛患者介入治疗和药物治疗与心脏事件的相关性.方法分析116例老年不稳定型心绞痛患者临床资料,分为药物治疗组和介入治疗组,随访两组患者心脏事件(心源性死亡、心肌梗死、心绞痛复发)的发生率及再住院、心功能分级情况.结果 6个月随访时,介入组和药物组心脏事件发生率分别为45.9%和85.3%(P＜0.01);再住院患者分别为20.3%和52.9%(P＜0.01);12,18个月随访时,介入组和药物组心脏事件的发生率分别为67.6%和100.0%,78.6%和100.0%,(P＜0.05);需再住院患者分别为35.2%和62.5%,37.5%和63.6%,(P＜0.05);治疗后介入组心功能分级比药物组好(P＜0.05);但两种治疗方法对老年不稳定型心绞痛患者心源性死亡,心肌梗死的发生无显著性差异(P＞0.05).结论介入治疗可明显降低老年不稳定型心绞痛患者心脏事件发生率,明显减少再住院率、使心功能分级明显改善.

Comparison study of interventional therapy with medical treatment with unstable angina in elderly patients

Objective: To evaluate the clinical effects and prognoses of interventional therapy and medical treatment in elderly patients with unstable angina (UA). Methods: 116 elderly patients with UA were divided into medical group and interventional group. Cardiac events consist of cardiac death and myocardial infarction and recurrence of angina. Compared the incidence of cardiac events and readmission rate and heart functional grade. Results: During 6-month follow-up, the cardiac events rates were 45.9% in interventional group and 85.3% in medical group (P <0.01). The readmission rate were 20.3% in interventional group and 52.9% in medical group (P <0.01). During 12-month follow-up, the cardiac events rates were 67.6% in interventional group and 100.0% in medical group (P <0.05). The readmission rate were 35.2% in interventional group and 62.5% in medical group (P <0.05). The follow-up period was 18 months, the cardiac events rates were 78.6% in interventional group and 100.0% in medical group (P <0.05). The readmission rate were37.5% in interventional group and 63.6% in medical group(P <0.05). The heart functional grade was better improved in interventional group than in medical group (P <0.05). There were no different in cardiac death, myocardial infarction between interventional group and medical group (P >0.05). Conclusions: Interventional therapy is an effective method to reduce cardiac events and to decrease readmission rate in elderly patients. It is more benefit for heart functional grade compared with medical therapy.