中华老年多器官疾病杂志
中華老年多器官疾病雜誌
중화노년다기관질병잡지
CHINESE JOURNAL OF MULTIPLE ORGAN DISEASES IN THE ELDERLY
2014年
6期
407-410
,共4页
刘海伟%韩雅玲%王效增%马颖艳%荆全民%王耿%王斌%徐凯%赵昕%关绍义
劉海偉%韓雅玲%王效增%馬穎豔%荊全民%王耿%王斌%徐凱%趙昕%關紹義
류해위%한아령%왕효증%마영염%형전민%왕경%왕빈%서개%조흔%관소의
冠状动脉疾病%左主干%经皮冠状动脉介入%女性%老年人
冠狀動脈疾病%左主榦%經皮冠狀動脈介入%女性%老年人
관상동맥질병%좌주간%경피관상동맥개입%녀성%노년인
coronary artery disease%left main coronary artery%percutaneous coronary intervention%female%aged
目的：探讨合并冠状动脉左主干（LMCA）病变老年女性患者经皮冠状动脉介入（PCI）术后的长期预后。方法从1997年12月～2012年10月，共有302例女性患者在我院首次行冠状动脉造影提示LMCA并行PCI，其中≥65岁的老年女性156例，年龄（72.0±4.31）岁；＜65岁非老年女性146例，年龄（55.5±7.06）岁。两组成功PCI患者随访（42.0±19.3）个月，比较两组患者的临床基本特征、冠状动脉病变特点、PCI特点及随访结果。结果老年组高血压和急性心肌梗死的比例较非老年组虽有增高的趋势，但差异无统计学意义。老年组的Syntax评分明显高于非老年组[（26.6±8.49） vs （23.5±9.10），P＜0.01]。老年组与非老年组PCI成功率均为100%，两组所采用手术术式、植入支架平均直径及长度，以及药物洗脱支架的比例均无明显差异。与非老年组相比较，老年组在总的主要不良心血管事件发生率、支架内血栓及全因死亡的发生率均无明显增加。结论合并LMCA病变的老年女性患者接受PCI是安全的，通过强化抗血小板治疗、选择合理的手术策略可改善其长期预后。
目的：探討閤併冠狀動脈左主榦（LMCA）病變老年女性患者經皮冠狀動脈介入（PCI）術後的長期預後。方法從1997年12月～2012年10月，共有302例女性患者在我院首次行冠狀動脈造影提示LMCA併行PCI，其中≥65歲的老年女性156例，年齡（72.0±4.31）歲；＜65歲非老年女性146例，年齡（55.5±7.06）歲。兩組成功PCI患者隨訪（42.0±19.3）箇月，比較兩組患者的臨床基本特徵、冠狀動脈病變特點、PCI特點及隨訪結果。結果老年組高血壓和急性心肌梗死的比例較非老年組雖有增高的趨勢，但差異無統計學意義。老年組的Syntax評分明顯高于非老年組[（26.6±8.49） vs （23.5±9.10），P＜0.01]。老年組與非老年組PCI成功率均為100%，兩組所採用手術術式、植入支架平均直徑及長度，以及藥物洗脫支架的比例均無明顯差異。與非老年組相比較，老年組在總的主要不良心血管事件髮生率、支架內血栓及全因死亡的髮生率均無明顯增加。結論閤併LMCA病變的老年女性患者接受PCI是安全的，通過彊化抗血小闆治療、選擇閤理的手術策略可改善其長期預後。
목적：탐토합병관상동맥좌주간（LMCA）병변노년녀성환자경피관상동맥개입（PCI）술후적장기예후。방법종1997년12월～2012년10월，공유302례녀성환자재아원수차행관상동맥조영제시LMCA병행PCI，기중≥65세적노년녀성156례，년령（72.0±4.31）세；＜65세비노년녀성146례，년령（55.5±7.06）세。량조성공PCI환자수방（42.0±19.3）개월，비교량조환자적림상기본특정、관상동맥병변특점、PCI특점급수방결과。결과노년조고혈압화급성심기경사적비례교비노년조수유증고적추세，단차이무통계학의의。노년조적Syntax평분명현고우비노년조[（26.6±8.49） vs （23.5±9.10），P＜0.01]。노년조여비노년조PCI성공솔균위100%，량조소채용수술술식、식입지가평균직경급장도，이급약물세탈지가적비례균무명현차이。여비노년조상비교，노년조재총적주요불양심혈관사건발생솔、지가내혈전급전인사망적발생솔균무명현증가。결론합병LMCA병변적노년녀성환자접수PCI시안전적，통과강화항혈소판치료、선택합리적수술책략가개선기장기예후。
Objective To investigate the long-term outcomes of percutaneous coronary intervention (PCI) in the old female patients with left main coronary artery (LMCA) disease. Methods A total of 302 female patients with LMCA disease who underwent PCI in our department from December 1997 to October 2012 were enrolled and retrospectively analyzed in this study. They were divided into the old group [≥65 years, with age of (72.0±4.31) years, n=156] and non-old group [<65 years, with age of (55.5±7.06) years, n=146]. The time of follow-up was (42.0±19.3) months in both groups after successful angioplasty. The basic clinical and angiographic characteristics, immediate results of PCI and major adverse cardiac event (MACE) defined as target vessel revascularization, acute myocardial infarction, and sudden cardiac death were analyzed between 2 groups during follow-up. Results The ratio of patients with hypertension and acute myocardial infarction were higher in old group than in non-old group, but with no significant difference between them (P>0.05). Compared with non-old group, the Syntax score of the old group was significantly higher [(26.6±8.49) vs (23.5±9.10), P<0.01]. All procedures were successfully completed in all-patients in both groups. The procedural strategies, the length and diameter of stent in LMCA and the ratio of drug eluting stent implantation were not significantly different between two groups. Meanwhile, the rate of MACE, stent thrombosis and all cause death were not significantly different between two groups. Conclusion PCI can be performed in old female LMCA patients successfully and safely. Anti-platelet therapy and optimized procedures will improve the long-term clinical outcomes of PCI in old females with LMCA disease.
