冠状动脉旋磨术加持续灌流法经皮冠状动脉腔内成形术治疗老年人冠心病的评估

目的探讨冠状动脉旋磨术（ＣＲＡ）加持续灌流法经皮冠状动脉腔内成形术（ＣＰＰＴＣＡ）治疗老年人冠心病的临床价值。方法对老年冠心病患者２０例３１支和非老年患者８例１３支冠状动脉（冠脉）病变行ＣＲＡ和ＣＰＰＴＣＡ，对照观察其临床疗效。结果术后两组冠脉狭窄处内径、跨狭窄压差、侧支循环积分、左室总体和局部功能均明显改善（Ｐ＜０．０５或＜０．０１），心绞痛均消失。结论ＣＲＡ加ＣＰＰＴＣＡ联合治疗老年和非老年人冠心病均可取得良好效果，但老年组远期效果略差。

The clinical value of coronary rotational atherectomy combined with continuous perfusion perctaneous transluminal coronary angioplasty in treatment of elderly patients with coronary heart disease

Objective Tostudy the clinical value of coronary rotational atherectomy(CRA)combined with continuous perfusion percutaneous transluminal coronary angioplasty(CPPTCA) in the elderlypatients., Methods Twenty elderly patients with 31 branches of severe diseased coronary arteries (group elderly) and 8 non elderly patients with 13 branches of severe stenosed arteries (group non elderly) were included in the study.CRA and CPPTCA were performed in both groups.Clinical symptoms,degrees of heart function were recorded and ECGs,stress test,echocardiograpy,lef tventricular and coronary angiograpy examination were performed before and after operation.Stenosed coronary diameter,collateral score,transstenosis blood pressure difference were measured before and after operation. Resuls The severity of coronary stenosis and left ventricular ejection fraction were similar between the two groups( P >0 05)before operation.Group elderly had a better collateral circulation and more severe abnormal left ventricular wall motion( P <0 05 or <0 01)than group non elderly.After operation,the severity of coronary stenosis,transstenosis blood pressure gradient,collateral circulation,left ventricular local and general function were significantly improved( P <0 05 or <0 01).Angina pectoris disappeared in both groups after operation. Conclusion These results suggest that CRA combined with CPPTCA is very effective in treatment of both group elderly and group non elderly,but the long term prognosis is slightly poorer in group elderly than in group non elderly..