高龄冠心病患者PCI治疗效果及安全性探讨

目的探讨80岁以上高龄冠心病（CHD）患者PCI治疗效果和安全性.方法选择2006年10月—2010年12月在北华大学附属医院心脏中心住院接受PC I治疗的80岁以上高龄CHD不稳定性心绞痛患者78例（高龄组）,和同期住院接受PCI治疗的40～60岁的中年CHD不稳定性心绞痛患者216例（中年组）,比较两组HCD患者易患因素、冠脉病变的Syntax评分、植入支架的数量及长度、效果和并发症等.结果易患因素在高龄组与中年组分别合并高血压病有8.9%与30.1%,糖尿病有12.6%与35.2%,吸烟有1%与72.9%,高血脂有5.9%与32.1%,两组比较差异有统计学意义（P〈0.05）.高龄组和中年组冠脉造影（CAG）示单支血管病变分别为20.5%和35.2%,双支血管病变为35.9%和46.8%,三支血管病变为44.9%和22.7%,冠脉病变的Syntax评分分别是20.9±6.7与14.6±7.8（P〉0.05）;平均每例植入支架的数量为（2.53±0.67）个与（1.92±0.86）个,植入支架长度为（23.01±5.88）mm与（18.67±5.01）mm（P〈0.05）.TIMI血流Ⅲ级率、急性或亚急性血栓发生率、出血性并发症、术中和术后1个月的死亡率两组无统计学意义（P〉0.05）.结论 80岁以上高龄冠心病患者行PCI治疗,近期效果和安全性与中年组相同.

Effect and Safety of PCI Used for Patients over 80 Years Old with Coronary Heart Disease

Objective To explore effect and safety of PCI used for the treatment of patients over 80 years old with coronary heart disease（CHD）.Method 78 cases over 80 years old with CHD unstable angina（older group） and without serious brain,lung,kidney and valve lesions and 216 cases in their ages from 40 to 60 years old with CHD unstable angina（middle aged-group） were selected,which were hospitalized for PCI therapy in the cardiovascular center of Affiliated Hospital of Beihua University from October 2006 to December 2010.The susceptibility factors,Syntax score of coronary lesions,stent＇s number and length,effect and safety and so on were comparatively researched.Results The susceptibility factors were some complications,such as hypertension 8.9% and 30.1%,diabetes 12.6% and 35.2%,smoking 1% and 72.9%,and dyslipidemia 5.9% and 32.1% respectively in older group and middle-aged group（P0.05）.In the older group and middle-aged group,CAG showed that single branch lesions were 20.5% and 35.2%,double branches lesions were 35.9% and 46.8%,three branches lesions were 44.9% and 22.7%.Syntax score of coronary lesions was 20.9± 6.7 and 14.6±7.8（P0.05）,and the number of implanted stents on average every example was（x±s）2.53±0.67 and 1.92±0.86,with the stent length（x±S）23.01±5.88mm and 18.67±5.01mm.（P0.05）.The rate of TIMI flow was level 3,but the incidence of acute or sub-acute thrombosis,the hemorrhagic complications and the mortality during the operation and postoperative one month were not significantly different（P0.05）.Conclusion The recent effect and the safety in the more than 80 years old patients with coronary heart disease（CHD） treated by PCI were as same as those of middle-aged group.