中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2011年
9期
710-713
,共4页
赵迎%张慧平%艾虎%李康%唐国栋%郑耐心%孙福成
趙迎%張慧平%艾虎%李康%唐國棟%鄭耐心%孫福成
조영%장혜평%애호%리강%당국동%정내심%손복성
血管成形术,经腔,经皮冠状动脉%冠状动脉疾病%随访研究
血管成形術,經腔,經皮冠狀動脈%冠狀動脈疾病%隨訪研究
혈관성형술,경강,경피관상동맥%관상동맥질병%수방연구
Angioplasty,transluminal,percutaneous coronary%Coronary artery disease%Follow-up studies
目的 观察年龄70岁及以上患者无保护左主干病变经皮冠状动脉介入治疗(PCI)预后的近期和长期临床随访结果。 方法 回顾性分析100例无保护左主干病变行药物洗脱支架置入患者临床资料，比较年龄70～90岁组(52例)和37～69岁组(48例)的病死率、心肌梗死、再次血运重建及其综合终点。 结果 两组危险因素、血管病变及置入支架等基线资料比较，差异无统计学意义（均P＞0.05）。70～90岁组和37～69岁组手术成功率分别为96.2％(50例)与97.9％（47例），差异无统计学意义(x2=1.75，P＞0.05)，住院病死率分别为3.8％（2例）与2.1％（1例），差异无统计学意义（x2 =0.27，P＞0.05）。两组平均随访时间分别为（22.0±2.5）个月与（23.0±11.7）个月，差异无统计学意义（t=-0.78，P＞0.05）。随访期间70～90岁与37～69岁组病死率、心肌梗死、再次PCI分别为3.8％（2例）与2.1％（1例）、7.7％（4例）与4.2％（2例）和13.5％（7例）与12.5％(6例)，差异无统计学意义（x2值分别为2.51、0.55、0.02，均P＞0.05），死亡、心肌梗死及再次血运重建综合终点分别为30.8％（16例）与18.8％（9例），差异无统计学意义(x2= 1.92，P＞0.05)。 结论 70岁及以上患者冠状动脉无保护左主干病变药物洗脱支架置入手术成功率高，长期随访安全有效。
目的 觀察年齡70歲及以上患者無保護左主榦病變經皮冠狀動脈介入治療(PCI)預後的近期和長期臨床隨訪結果。 方法 迴顧性分析100例無保護左主榦病變行藥物洗脫支架置入患者臨床資料，比較年齡70～90歲組(52例)和37～69歲組(48例)的病死率、心肌梗死、再次血運重建及其綜閤終點。 結果 兩組危險因素、血管病變及置入支架等基線資料比較，差異無統計學意義（均P＞0.05）。70～90歲組和37～69歲組手術成功率分彆為96.2％(50例)與97.9％（47例），差異無統計學意義(x2=1.75，P＞0.05)，住院病死率分彆為3.8％（2例）與2.1％（1例），差異無統計學意義（x2 =0.27，P＞0.05）。兩組平均隨訪時間分彆為（22.0±2.5）箇月與（23.0±11.7）箇月，差異無統計學意義（t=-0.78，P＞0.05）。隨訪期間70～90歲與37～69歲組病死率、心肌梗死、再次PCI分彆為3.8％（2例）與2.1％（1例）、7.7％（4例）與4.2％（2例）和13.5％（7例）與12.5％(6例)，差異無統計學意義（x2值分彆為2.51、0.55、0.02，均P＞0.05），死亡、心肌梗死及再次血運重建綜閤終點分彆為30.8％（16例）與18.8％（9例），差異無統計學意義(x2= 1.92，P＞0.05)。 結論 70歲及以上患者冠狀動脈無保護左主榦病變藥物洗脫支架置入手術成功率高，長期隨訪安全有效。
목적 관찰년령70세급이상환자무보호좌주간병변경피관상동맥개입치료(PCI)예후적근기화장기림상수방결과。 방법 회고성분석100례무보호좌주간병변행약물세탈지가치입환자림상자료，비교년령70～90세조(52례)화37～69세조(48례)적병사솔、심기경사、재차혈운중건급기종합종점。 결과 량조위험인소、혈관병변급치입지가등기선자료비교，차이무통계학의의（균P＞0.05）。70～90세조화37～69세조수술성공솔분별위96.2％(50례)여97.9％（47례），차이무통계학의의(x2=1.75，P＞0.05)，주원병사솔분별위3.8％（2례）여2.1％（1례），차이무통계학의의（x2 =0.27，P＞0.05）。량조평균수방시간분별위（22.0±2.5）개월여（23.0±11.7）개월，차이무통계학의의（t=-0.78，P＞0.05）。수방기간70～90세여37～69세조병사솔、심기경사、재차PCI분별위3.8％（2례）여2.1％（1례）、7.7％（4례）여4.2％（2례）화13.5％（7례）여12.5％(6례)，차이무통계학의의（x2치분별위2.51、0.55、0.02，균P＞0.05），사망、심기경사급재차혈운중건종합종점분별위30.8％（16례）여18.8％（9례），차이무통계학의의(x2= 1.92，P＞0.05)。 결론 70세급이상환자관상동맥무보호좌주간병변약물세탈지가치입수술성공솔고，장기수방안전유효。
Objective To observe the in-hospital and long-term results in patients with drugeluting stenting age≥70 years with unprotected left main (UML) coronary artery disease.Methods In this retrospective study, 100 patients with UML disease were enrolled. Death, myocardial infarction, repeated revascularization and composite end points during follow-up were compared between groups aged ≥70 years and control aged ＜70 years.Results There was no remarkable distinction between the two groups in cardiovascular risk factors, anatomic findings of coronary artery disease and stent variables. No significant differences were found between the two groups in procedure success rate[96.2％ (50 cases) vs. 97.9％ (47 cases) ,x2 = 1.75, P＞0.05] and in-hospital mortality [3.8％ (2 cases) vs. 2.1％ ( 1 case), x2 = 0.27, P ＞0.05]. Patients were clinically followed for an average time of 22.0 months in the elderly group and 23.0 months in the control group (t= -0.78, P＞0.05). There were no significant differences in death[3.9％(2 cases) vs. 2.1％(1 case) ,x2 =2.51,P＞0.05], myocardial infarction[7.7 ％ (4 cases) vs. 4.2 ％ (2 cases), x2 = 0.55, P＞0.05], repeated revascularization [13.5％ (7 cases) vs. 12.5％(6 cases) ,x2 =0.02, P＞0.05]and composite endpoints of death, myocardial infarction and repeated revascularization[30.7％ (16 cases)vs. 18.8％ (9 cases),x2 = 1.92, P＞0.05] between the elderly group and the control group.Conclusions The procedure success rate and in-hospital mortality of drug-eluting stent implantation in elderly patients aged≥70 years old with unprotected left main coronary artery are comparable to group aged＜70 years. The main endpoints including death, myocardial infarction and repeated revascularization are favorable at about 2 years clinical follow up. It is safe and efficacious to implant drug-eluting stent in patients aged ≥70 years old with unprotected left main coronary artery.
