中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2011年
5期
378-382
,共5页
张峻%乔树宾%朱俊%陈珏%杨伟宪%梁岩%邵春丽
張峻%喬樹賓%硃俊%陳玨%楊偉憲%樑巖%邵春麗
장준%교수빈%주준%진각%양위헌%량암%소춘려
急性冠状动脉综合征%年龄因素%血管成形术,经腔,经皮冠状动脉
急性冠狀動脈綜閤徵%年齡因素%血管成形術,經腔,經皮冠狀動脈
급성관상동맥종합정%년령인소%혈관성형술,경강,경피관상동맥
Acute coronary syndrome%Age factors%Angioplasty,transtuminal,percutaneous coronary
目的 比较非ST段抬高急性冠状动脉(冠脉)综合征不同年龄患者介入治疗的疗效和安全性.方法 非ST段抬高的急性冠脉综合征患者随机分配至早期介入组(24 h内接受冠脉造影)和延迟介入组(36 h后接受冠脉造影).主要研究终点为180 d随访时死亡、心肌梗死(MI)、卒中的复合终点.结果 共有815例患者入选,其中≥75岁患者198例,＜75岁患者617例.≥75岁患者主要终点事件发生率明显高于＜75岁患者(18.7%比9.2%,P=0.00).＜75岁患者早期介入组主要终点事件发生率明显低于延迟介入组(6.5%比12.5%,P=0.01).≥75岁患者早期介入组和延迟介入组间主要终点事件发生率差异无统计学意义(16.5%比21.3%,P=0.39).结论 非ST段抬高急性冠脉综合征介入治疗中≥75岁患者病死率和新发MI发生率高于＜75岁患者;＜75岁患者早期介入治疗可减少MI的发生率,≥75岁患者早期和延迟介入治疗差异无统计学意义.
目的 比較非ST段抬高急性冠狀動脈(冠脈)綜閤徵不同年齡患者介入治療的療效和安全性.方法 非ST段抬高的急性冠脈綜閤徵患者隨機分配至早期介入組(24 h內接受冠脈造影)和延遲介入組(36 h後接受冠脈造影).主要研究終點為180 d隨訪時死亡、心肌梗死(MI)、卒中的複閤終點.結果 共有815例患者入選,其中≥75歲患者198例,＜75歲患者617例.≥75歲患者主要終點事件髮生率明顯高于＜75歲患者(18.7%比9.2%,P=0.00).＜75歲患者早期介入組主要終點事件髮生率明顯低于延遲介入組(6.5%比12.5%,P=0.01).≥75歲患者早期介入組和延遲介入組間主要終點事件髮生率差異無統計學意義(16.5%比21.3%,P=0.39).結論 非ST段抬高急性冠脈綜閤徵介入治療中≥75歲患者病死率和新髮MI髮生率高于＜75歲患者;＜75歲患者早期介入治療可減少MI的髮生率,≥75歲患者早期和延遲介入治療差異無統計學意義.
목적 비교비ST단태고급성관상동맥(관맥)종합정불동년령환자개입치료적료효화안전성.방법 비ST단태고적급성관맥종합정환자수궤분배지조기개입조(24 h내접수관맥조영)화연지개입조(36 h후접수관맥조영).주요연구종점위180 d수방시사망、심기경사(MI)、졸중적복합종점.결과 공유815례환자입선,기중≥75세환자198례,＜75세환자617례.≥75세환자주요종점사건발생솔명현고우＜75세환자(18.7%비9.2%,P=0.00).＜75세환자조기개입조주요종점사건발생솔명현저우연지개입조(6.5%비12.5%,P=0.01).≥75세환자조기개입조화연지개입조간주요종점사건발생솔차이무통계학의의(16.5%비21.3%,P=0.39).결론 비ST단태고급성관맥종합정개입치료중≥75세환자병사솔화신발MI발생솔고우＜75세환자;＜75세환자조기개입치료가감소MI적발생솔,≥75세환자조기화연지개입치료차이무통계학의의.
Objective To investigate the effect and safety of early intervention and delayed intervention therapy on elderly patients and younger patients with non-ST segment elevation acute coronary syndrome. Methods The patients with non-ST segment elevation acute coronary syndrome were randomly divided into early intervention group (coronary angiography taken within 24 hours after grouping) and delayed intervention group ( coronary angiography taken after 36 hours after grouping). The primary endpoint was a composite endpoint of death, myocardial infarction and stroke during 180 days follow-up. Results A total of 815 patients were enrolled, including 198 elderly patients aged 75 years and above, and 617 younger patients aged below 75 years. The elderly patients had a greater incidence of the primary endpoint than that of younger patients ( P = 0. 00). The primary endpoint of early intervention group were obviously lower than that of delayed intervention group of younger patients ( P = 0. 01 ). There was no significant difference in primary endpoint incidence of early intervention group and delayed intervention group of the elderly patients (P =0. 39). Conclusions The elderly patients with non-ST segment elevation acute coronary syndrome who underwent intervention had greater incidence of death and myocardial infarction. Early intervention reduced the rate of myocardial infarction for the younger patients. There was no significant difference in primary endpoint incidence between early intervention and delayed intervention among elderly patients.
