50例75岁以上老年冠心病介入治疗疗效观察.doc

50例75岁以上老年冠心病介入治疗疗效观察[摘要] 目的：探讨高龄冠心病患者进行冠状动脉介入治疗的安全性及疗效。方法：回顾性分析2004年9月～2007年9月收入我院行冠状动脉介入术的50例75岁以上老年患者的临床资料，观察其冠状动脉造影结果、经皮冠状动脉介入术成功率、住院期间的治疗效果及随访结果。结果：50例病变相关动脉为前降支35处,右冠状动脉19处,回旋支10处。单支病变26例，双支病变18例，三支病变6例；PCI成功率98%；术后随访6～40个月，7例再次出现胸痛发作，3例患者行PCI术,其中1例为原有支架闭塞；急性心肌梗死死亡1例,为心肌梗死后心功能衰竭。结论：高龄老年患者选择冠状动脉介入治疗安全可靠，值得临床推广使用。 [关键词] 高龄；冠状动脉疾病；血管成形术；经皮冠状动脉；支架 [中图分类号]R541.4 [文献标识码]C [文章编号]1673-7210（2008）08（c）-246-02 The efficacy of Coronary in tervention in the freatment of eldly patients with Coronary hearf disease CHEN Yong-sheng,LEI Li (The Fifth Hospital affiliated Zhengzhou University,zhengzhou 450052,China) [Abstract] Objective:To investigate elderly patients with coronary heart disease for coronary intervention of the safety and efficacy. Methods: Retrospective analysis of our hospital from September 2004 to September 2007 income hospital coronary intervention of the 50 cases of elderly patients over 75 years of clinical data and to observe the results of coronary angiography and percutaneous coronary intervention success rate of hospitalization during the treatment and follow-up results. Results:50 patients with lesions associated with anterior descending artery was 35,and the right coronary artery 19,circumflex 10.26 patients with single-vessel disease,18 patients with double-vessel disease,and three lesions 6，the survival rate of PCI is 98%.we follow up from 6 to 40 months after surgery,Chest pain occurred again in 7 patients, 3 patients performed PCI, and 1 case had stent obstruction,1 case died of AMI.Conclusion: PCI is safe and worth of been used wider for the eldly patients. [Key words] elder patients;coronary artery disease;angioplasty;percutaneous coronary;stent 随着介入治疗的进展，药物支架及GPⅡb/Ⅲa抑制剂的应用，老年冠心病介入治疗成功率逐年提高，美国心脏学会-国家心血管数据登记处(ACC-NCDR)[1]共入选8828例老年患者(平均年龄84岁)，PCI(75%支架)的造影成功率达93%，住院死亡率为3.8%。我院采用PCI治疗了50例高龄冠心病患者，临床效果满意，现报道如下： 1资料与方法 1.1临床资料 我院2004年9月～2007年9月收治老年急性冠脉综合征(ACS)患者，年龄75～90(80.7±6.8)岁，共50例行介入治疗，其中男30例，女20例；其中不稳定型心绞痛7例，急性