中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
1期
24-26
,共3页
刘向儒%唐春仕%王才安%李世煌%陈瑛%彭露%肖侃
劉嚮儒%唐春仕%王纔安%李世煌%陳瑛%彭露%肖侃
류향유%당춘사%왕재안%리세황%진영%팽로%초간
高龄%多支冠状动脉病变%部分血运重建%T波峰末间期
高齡%多支冠狀動脈病變%部分血運重建%T波峰末間期
고령%다지관상동맥병변%부분혈운중건%T파봉말간기
Elderly people%Multi-branch coronary artery stenosis%Incomplete coronary revascularization%Tpeak-Tend interval
目的 评价部分血运重建介入治疗对高龄冠状动脉粥样硬化性心脏病(高龄冠心病)患者的效果.方法 收集2008-2011年接受部分血运重建介入治疗的48例高龄(年龄≥75岁)冠心病多支病变患者的临床资料,对比分析经皮冠状动脉介入治疗术前、术后6个月的随访结果.结果 部分血运重建后6个月较术前相比,左心室射血分数明显升高,术前为(39.82±8.23)％、术后6个月为(48.10±7.19)％(t =4.31,P＜0.01)；脑钠肽明显下降,术前为(793.57±87.53) ng/L、术后6个月为(575.17±67.27) ng/L(t =5.27,P＜0.01)；校正的T波峰末间期(Tp-Te √RR)和T波峰末间期与QT间期的比值(Tp-Te/QT)明显下降,术前Tp-Te√RR为(147.81±17.32) ms、Tp-Te/QT为0.30±0.07,术后6个月Tp-Te√RR为(96.38±10.79) ms、Tp-Te/QT为0.25±0.05,差异有统计学意义(t值为5.86、4.17,P均＜0.05)；术后6个月左心室舒张末期容积、左心室收缩末期容积较前增加,但差异无统计学意义(P均＞0.05).结论 部分血运重建介入治疗可以改善高龄多支冠状动脉病变患者心功能和心脏电生理活动的稳定性,但不能改善患者的左心室重构.
目的 評價部分血運重建介入治療對高齡冠狀動脈粥樣硬化性心髒病(高齡冠心病)患者的效果.方法 收集2008-2011年接受部分血運重建介入治療的48例高齡(年齡≥75歲)冠心病多支病變患者的臨床資料,對比分析經皮冠狀動脈介入治療術前、術後6箇月的隨訪結果.結果 部分血運重建後6箇月較術前相比,左心室射血分數明顯升高,術前為(39.82±8.23)％、術後6箇月為(48.10±7.19)％(t =4.31,P＜0.01)；腦鈉肽明顯下降,術前為(793.57±87.53) ng/L、術後6箇月為(575.17±67.27) ng/L(t =5.27,P＜0.01)；校正的T波峰末間期(Tp-Te √RR)和T波峰末間期與QT間期的比值(Tp-Te/QT)明顯下降,術前Tp-Te√RR為(147.81±17.32) ms、Tp-Te/QT為0.30±0.07,術後6箇月Tp-Te√RR為(96.38±10.79) ms、Tp-Te/QT為0.25±0.05,差異有統計學意義(t值為5.86、4.17,P均＜0.05)；術後6箇月左心室舒張末期容積、左心室收縮末期容積較前增加,但差異無統計學意義(P均＞0.05).結論 部分血運重建介入治療可以改善高齡多支冠狀動脈病變患者心功能和心髒電生理活動的穩定性,但不能改善患者的左心室重構.
목적 평개부분혈운중건개입치료대고령관상동맥죽양경화성심장병(고령관심병)환자적효과.방법 수집2008-2011년접수부분혈운중건개입치료적48례고령(년령≥75세)관심병다지병변환자적림상자료,대비분석경피관상동맥개입치료술전、술후6개월적수방결과.결과 부분혈운중건후6개월교술전상비,좌심실사혈분수명현승고,술전위(39.82±8.23)％、술후6개월위(48.10±7.19)％(t =4.31,P＜0.01)；뇌납태명현하강,술전위(793.57±87.53) ng/L、술후6개월위(575.17±67.27) ng/L(t =5.27,P＜0.01)；교정적T파봉말간기(Tp-Te √RR)화T파봉말간기여QT간기적비치(Tp-Te/QT)명현하강,술전Tp-Te√RR위(147.81±17.32) ms、Tp-Te/QT위0.30±0.07,술후6개월Tp-Te√RR위(96.38±10.79) ms、Tp-Te/QT위0.25±0.05,차이유통계학의의(t치위5.86、4.17,P균＜0.05)；술후6개월좌심실서장말기용적、좌심실수축말기용적교전증가,단차이무통계학의의(P균＞0.05).결론 부분혈운중건개입치료가이개선고령다지관상동맥병변환자심공능화심장전생리활동적은정성,단불능개선환자적좌심실중구.
Objective To evaluate the outcome of incomplete revasculariszation by percutaneous coronary intervention (PCI) in elderly patients with coronary artery disease.Methods Data of 48 patients (age≥75 years old) underwent incomplete coronary revascularization during the period from 2008 to 2011 were collected.Their data before PCI and the 6 months follow-up results were comparatively analyzed.Results Six months after incomplete coronary revascularization,the LVEF was higher than that before revascularization ((48.10 ± 7.19)％ vs (39.82 ± 8.23)％) and BNP declined significantly ((575.17 ± 67.27) ng/L vs (793.57 ± 87.53)ng/L).T peak-T end (Tp-Te) √RR and Tp-Te/QT also declined significantly (Tp-Te √RR:(96.38 ± 10.79)ms vs (147.81 ± 17.32)ms;Tp-Te/QT:(0.25 ±0.05) vs (0.30 ±0.07)) (P ＜0.05).Six months after PCI,LVEDV and LVESV were higher than those before surgery,but there was no significant difference(P ＞ 0.05).Conclusion Incomplete coronary revascularization can improve heart function and stability of cardiac electrophysiology in elderly patients with coronary artery disease,but it can not prevent the development of left ventricular remodeling.
