摘要
目的分析不同年龄患者经皮冠状动脉介入术(PCI)特点及手术效果差异。方法选择2015年1月—2016年6月长海医院和上海中医药大学附属第七人民医院心血管内科接受PCI术的患者2 308例作为研究对象。根据年龄分为<65岁组(1033例)、≥65岁组(1275例),比较2组患者的基础疾病/既往病史、合并疾病、PCI相关指标及主要不良心血管事件(MACE)的发生情况。结果与<65岁组比较,≥65岁组患者中女性的比例、高血压病史、AMI病史、脑卒中病史的比例明显增高(X^2=60.80、157.48、51.57、24.47,P均<0.001),CK-MB、CTnI、SCr水平明显升高(t=34.16、20.76、24.47、44.29,P均<0.001),吸烟史、高脂血症比例及LVEF明显降低,差异均有统计学意义(X^2=23.90、5.62,t=32.91,P<0.05)。<65岁组以单支、双支冠脉病变以及A型、B型病变形态多见,支架置入数、左主干病变比例明显减少,PCI术的成功率明显升高,差异均有统计学意义(X^2=26.65、5.61、8.88,P<0.01)。2组PCI术后MACE(心源性死亡、AMI、TVR、脑卒中)的发生率比较,差异均无统计学意义(P>0.05)。结论不同年龄PCI患者的临床特点及手术效果存在较大的差异,老年患者危险因素、病变严重程度、合并症均有所增加,但采用PCI治疗仍具有较高成功率,有助于改善预后。
Objective To investigate clinical characteristics and procedure effect between different ages in patients with percutaneous coronary intervention （PCI）. Methods The total of 2 308 patients with PCI who received treatment from 2015 Jan to 2016 June in the department of cardiology of the 7th People＇s Hospital affiliated Shanghai University of Traditional Chinese Medicine were analyzed retrospectively, and the patients were divided into 〈 65 years old group （n = 1 033 ）and ≥ 65 years old group（ n = 1 275 ）. The risk factors, combined disease, PCI related indicators, and the occurrence of major adverse cardiac events（MACE） in two groups were compared. Result Compared with 〈 65 years old： group, there were significant increase in the percentage of female, history of hypertension, AMI and stroke in ≥ 65 years old group（ χ^2 = 60.80, χ^2 = 157.48, χ^2 =51.57,χ^2 =24.47,all P 〈0. 001）, the levels of CK-MB,CTnI,SCr were also increased obviously（t =34.16,20.76, 24.47,44.29, all P 〈 0.001 ）, history of smoking, hyperlipemia and LVEF was significantly reduced （ χ^2 = 23.90, P 〈 0.001, χ^2 = 5.62,P = 0. 018,t = 32.91, P 〈 0. 001 ）. 〈 65 years old group was given priority to single and double vessel coronary disease, type A and B, number of stent placement and the proportion of left main lesion were significantly reduced, and the success rate of PCI was significant higher than that in 〉165 years old group（χ^2 =26.65 ,P 〈0.001 ,χ^2 = 5.61 ,P =0.021 ,χ^2 = 8.88 ,P = 0. 003）. There was no significant difference on incidence of MACE including cardiac death, AMI,TVR, stroke after PCI between two group（χ^2 =0.13,P=0.710,χ^2 =0.58,P =0.447,χ^2 =1.51,P=0.219,χ^2 =2.45,P =0.055）. Conclusion The clinical characteristics and procedure effects of PCI patients are of great age difference. The risk factors 1 disease severity and complications of elderly patients have increased. However, PCI treatment still has a high success rate.
出处
《疑难病杂志》
CAS
2018年第1期31-34,共4页
Chinese Journal of Difficult and Complicated Cases
基金
上海市科委科技支撑项目(13411950302)
关键词
经皮冠状动脉介入术
年龄
病例特点
手术效果
Percutaneous coronary intervention
Age
Clinical characteristic
Proeedure effect
