CAJ | 학술논문

目的：探讨经皮冠状动脉介入（PCI）治疗高龄不稳定性心绞痛的临床疗效。方法将118例不稳定性心绞痛患者按是否行 PCI 治疗分为2组：PCI 组（65例）和 ODT 组（53例）。PCI 组患者采用 PCI 治疗，术后采用阿司匹林肠溶片、硫酸氢氯吡格雷治疗。ODT 组患者采用阿司匹林肠溶片、硫酸氢氯吡格雷治疗，同时采用单纯优化药物治疗。观察2组患者治疗6个月后血清肾素活性（PRA）、血管紧张素Ⅱ（AngⅡ）、醛固酮（ALD）、去甲肾上腺素（NE）、肾上腺素（E）、肌酐（Cr）及左心室舒张内径（LVDD）、左心室射血分数（LVEF）差值，胸痛缓解率、生存率、再次住院率和主要不良心血管事件（非致死性心肌梗死、脑卒中）。结果PCI 组患者治疗6个月后血清 PRA、Ang Ⅱ、ALD、NE、E 及 LVEF 差值、再次住院率均明显低于 ODT 组，LVDD 差值、胸痛症状缓解率均明显高于 ODT 组（均P ＜0．05）。结论PCI 较 ODT 能够显著降低高龄不稳定性心绞痛患者心脏相关神经内分泌因子的水平，PCI 的治疗疗效明显优于单纯优化药物治疗。
목적：탐토경피관상동맥개입（PCI）치료고령불은정성심교통적림상료효。방법장118례불은정성심교통환자안시부행 PCI 치료분위2조：PCI 조（65례）화 ODT 조（53례）。PCI 조환자채용 PCI 치료，술후채용아사필림장용편、류산경록필격뢰치료。ODT 조환자채용아사필림장용편、류산경록필격뢰치료，동시채용단순우화약물치료。관찰2조환자치료6개월후혈청신소활성（PRA）、혈관긴장소Ⅱ（AngⅡ）、철고동（ALD）、거갑신상선소（NE）、신상선소（E）、기항（Cr）급좌심실서장내경（LVDD）、좌심실사혈분수（LVEF）차치，흉통완해솔、생존솔、재차주원솔화주요불양심혈관사건（비치사성심기경사、뇌졸중）。결과PCI 조환자치료6개월후혈청 PRA、Ang Ⅱ、ALD、NE、E 급 LVEF 차치、재차주원솔균명현저우 ODT 조，LVDD 차치、흉통증상완해솔균명현고우 ODT 조（균P ＜0．05）。결론PCI 교 ODT 능구현저강저고령불은정성심교통환자심장상관신경내분비인자적수평，PCI 적치료료효명현우우단순우화약물치료。
ABSTRACT:Objective To investigate the clinical efficacy of percutaneous coronary intervention (PCI)for unstable angina in elderly patients.Methods A total of 118 elderly patients with unsta-ble angina were divided into two groups.Patients in PCI group(n=65)were given PCI and post-operative treatment with enteric-coated aspirin tablets and clopidogrel bisulfate.Patients in ODT group(n=53)were treated with enteric-coated aspirin tablets,clopidogrel bisulfate and optimal drug therapy(ODT).Serum renin activity,angiotensin Ⅱ (AngⅡ),aldosterone(ALD),norepi-nephrine(NE),epinephrine(E),creatinine(Cr),left ventricular diastolic inner diameter(LVDD) difference,left ventricular ejection fraction(LVEF)difference,chest pain remission rate,survival rate,readmission rate,and incidence of adverse cardiovascular events(nonfatal myocardial infarc-tion and stroke)were observed after treatment for 6 months.Results Compared with ODT group,serum PRA,Ang Ⅱ,ALD,NE,E,LVEF difference and readmission rate decreased and LVDD difference and chest pain remission rate increased in ODT group after treatment for 6 months(P <0.05).Conclusion PCI is superior to ODT for reducing the levels of heart-related neuroendocrine factors and treating unstable angina in elderly patients.