老年人急性冠脉综合征介入治疗.doc

老年人急性冠脉综合征介入治疗 　【摘要】 　　目的： 评价老年急性冠脉综合征病人（GACS）接受介入治疗的条件、并发症和近远期效果。方法： 分析1999年1月至2000年12月住院的GACS病人86例，分为早期介入治疗组26例（30.2%，住院3天内）；择期介入治疗组28例（32.6%，住院3天至2周）；药物治疗组32例（37.2%，C组）。比较3组病人的下列参数：年龄、病史、病重程度、IABP使用率、介入并发症、住院并发症、病死率、住院时间、随访资料（包括再住院率、病死率、介入治疗和搭桥率）。结果： 3组病人的年龄和病史基本相同（Pgt;0.05）。介入治疗组的病重程度、IABP使用率明显大于药物治疗组（Plt;0.05）；住院病死率、住院时间、再住院率、随访病死率、随访介入治疗和搭桥率明显低于药物治疗组（Plt;0.05）。早期介入治疗组的病重程度和1ABP使用率明显大于择期介入治疗组（Plt;0.05），但两组的操作并发症、住院并发症和病死率无差别（Pgt;0.05）。结论： ①介入治疗能明显降低老年危重GACS病人的住院病死率和并发症，缩短住院时间，改善随访结果；②早期介入治疗是处理GACS危重症的有效方法；③提高GACS危重病人的介入治疗率是改善其整体预后的重要措施。 【关键词】 老年人急性冠脉综合征　介入治疗 　　The Effect of Percutaneous Coronary Revascularization on Geriatric Acute Coronary Syndrome　　 　　Abstract Objective: The purpose of the study is to evaluate the using indication, complication, immediate and longterm effect of percutaneous coronary revascularization (PCR) in geriatric patients with acute coronary syndrome (GACS). Methods: Consecutive 86 GACS patients were admitted from Jan. of 1999 to Dec. of 2000. They were divided into three groups of ① early PCR group (PCR was conducted within 3 days after admission, 26 cases, 30.2%)； ② elective PCR group (PCR was completed in 3 days to 2 weeks after admission, 28 cases, 32.6%)； ③ medication group (32 cases, 37.2%). Following parameters were compared between 3 groups: age, history, sickness degree, IABP rate, PCR complication, total complication, mortality, hospital time, fellowup data including readmission rate, fellowup mortality, reCABG or PCI rate. Results： The age and history were comparable among 3 groups (Pgt;0.05). The sickness degree and IABP rate in two PCR groups were obviously higher than those in the medication group (Plt;0.05), but the word mortality, hospitalization time, readmission rate, followup mortality, reCABG or PCR rate were significantly lower than those in medication group (Plt;0.05). However, the procedure complication, total complication and mortality were similar between two PCR groups. Conclusions:① PCR could significa