老年冠心病患者慢性闭塞病变介入治疗特点及预后-内科急危重症杂志.doc

老年冠心病患者慢性闭塞病变介入治疗特点及预后分析 邱茹洁. 【摘要】 目的 分析我院老年冠心病患者合并冠状动脉慢性闭塞病变（coronary chronic total occlusion ，CTO）经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）的临床特点及预后，以此探讨老年冠心病患者CTO病变行PCI治疗的可行性和安全性。方法 回顾性分析我院2012年01月至12月住院经冠脉造影检查证实冠状动脉慢性闭塞并行PCI治疗的患者232例，按年龄分组，对比分析老年组[年龄≥60岁，平均(66.±5.4岁]108例及中青年组[年龄＜60岁，平均(51.±6.3)岁]124例患者的临床特征、冠状动脉造影血管病变特点、闭塞血管开通率、围术期并发症及预后等情况。结果 老年组患者冠心病家族史比例低于中青年组，与PCI相关的心肌梗死的发生率较中青年组高，差异具有统计学意义(P0.05)。但两组患者的闭塞病变血管支数及部位、平均造影剂用量、手术时间、应用导丝数量及球囊数量、支架植入数、闭塞病变开通率、随访术后心功能改善情况、主要心血管事件发生率差异均无统计学意义(P0．05)。结论 老年冠心病患者合并CTO病变行介入治疗的手术成功率和中青年CTO患者相当，手术并发症少，术后心功能明显改善, 老年冠心病患者CTO病变的介入治疗安全可行。 【关键词】 老年人；冠状动脉；慢性完全闭塞病变；经皮冠状动脉介入治疗；回顾性分析 【Abstract】 Objective Analysis of elderly patients with coronary heart disease complicated with coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) of the clinical characteristics and prognosis, and discuss the feasibility and safety of elderly patients with coronary heart disease were treated with PCI CTO。Methods Were retrospectively analyzed in our hospital between January and December 2012 chronic coronary artery occlusion was confirmed by coronary angiography examination and percutaneous coronary intervention (PCI) in 232 cases, by age group, comparative analysis of the older group [ Age ≥ 60 years, mean (66.6 ± 5.4) years] 108 cases , and the young group [ age 60 years , clinical characteristics mean (51.3 ± 6.3) years] of 124 patients with clinical characteristics, coronary angiography in vascular pathology, occlusive vascular patency rate, perioperative complications and prognosis o f the situation . Results Family history of coronary heart disease in elderly patients was significantly lower than the ratio of the young group , the incidence of elderly patients with myocardial infarction associated with PCI higher than young group,the differences were statistically significant (P 0.05). However, occlusion of blood vessels and the parts count two groups of patients , the average amount of contrast agent