澳门地区老年患者冠状动脉介入治疗术临床评价.docVIP

澳门地区老年患者冠状动脉介入治疗术的临床评价 Clinical Analysis of Percutaneous Coronary Intervention in Elderly Patients with Coronary Artery Disease in Macau 吴宝群 邓锡伟 李兆文 金 椿 WU Baoqun, DENG Xiwei, LEI Sioman,JIN Chun 澳门镜湖医院心内科 Department of cardiology, Kiang Wu Hospital Macau 中图分类号：R541 文献标识码：A 文章编号：1818－0086（2008）01 摘 要:目的 评估澳门地区75岁以上冠心病患者接受冠状动脉介入治疗术(PCI)的安全性和临床疗效。 对自2004年1月至2007年6月共181例年龄≧75岁的冠心病患者临床特点、冠脉病变特点、PCI成功率、手术并发症进行回顾性分析，并与223例75岁患者作比较。其中3支病变68例(37.5%)，复杂病变274处(88.1%)，311处靶病变进行PTCA、支架植入术。 75岁以上病例成功率95.6%，小于75岁病例为96.8%，两组比较无显著性差异(P0.05)。病变的成功率为93.6%，48例急性心肌梗塞治疗犯罪血管开通率100%，慢性闭塞病变(CTO)22处，成功率77.3%，170例患者行冠脉支架植入术(93.9%)，术前靶血管平均狭窄(87.6±10.4)%，术后平均残余狭窄(5.7±6.5)%。严重并发症5例(2.76%)，死亡率2.76%，小于75岁病例严重并发症6例(2.69%)，死亡率为2.69%，两组比较无显著性差异(P0.05)。 高龄因素对冠心病患者选择性冠状动脉介入治疗术成功率和安全性无显著影响。 冠心病；冠状动脉介入治疗术；老年 Abstract：Objective To assess the technical success and safety of percutaneous coronary intervention in patients over 75 years old in Macau. Methods Between January 2004 and June 2007, a total retrospective study of 181 patients aged 75 years or older who were undergone percutaneous coronary intervention compared with patients less than 75 years old in clinical characteristics,characteristics of coronary arteries,successful rate,complications. 68 of whom with triple vessel coronary disease(37.5%).274 of 311 target lesions were complex lesions(88.1%). Results Procedural success rate(95.6% vs 96.8%) were no significant different between the two groups(P0.05),primary lesion success rate was 93.6%,48 infarct-related artries in patients with AMI were successfully revascularized (100%).Procedural success rate in CTO was 77.3%.170 patients undergone coronary stenting(93.9%).The stenosis rate of target lesions was reduced from 87.6±10.4% to 5.7±6.5%.The main complication rate(2.76% vs 2.69%) and mortality rate(2.76% vs 2.69%) were no significant diffetent between the two groups(P0.05). Conclusion Age may produce non-significant influence on procedural success rate and safety in percutaneous co