高龄急性冠脉综合征患者经皮冠状动脉介入治疗100例临床剖析.docVIP

高龄急性冠脉综合征患者经皮冠状动脉介入治疗100例临床剖析 　　[摘要] 目的 探讨高龄急性冠状动脉综合征患者行经皮冠状动脉介入治疗的临床疗效和预后。 方法 100例高龄ACS患者均行冠脉造影证实病变，20例患者行急诊PCI术，80例行择期PCI术，观察近、远期主要不良心脑血管事件的发生及临床预后。 结果 96例介入治疗成功，治疗成功率为96.0%；靶病变治疗成功率为95.6%（151/158），随访期间发生15例不良心脑血管事件。 结论 高龄ACS患者行PCI术手术成功率高、主要不良心脑血管事件发生率低，可明显改善患者的临床预后。 　　[关键词] 急性冠脉综合征；经皮冠状动脉；介入治疗；临床分析 　　[中图分类号] R54 [文献标识码] A [文章编号] 1674-4721（2012）06（a）-0047-02 　　Clinic analysis of percutaneous coronary intervention treating 100 cases with acute coronary syndromes in the elderly 　　CHEN Derong HE Hao JIANG Junhua 　　Chang′an Hospital in Dongguan City of Guangdong Province, Dongguan 523843, China 　　[Abstract] Objective To explore the efficacy and the clinical outcome of percutaneous coronary interventions (PCI) on elderly patients with acute coronary syndrome (ACS). Methods One hundred elderly patients with ACS were diagnosed and confirmed by coronary angiography. Primary PCI was performed in 20 patients and 80 patients underwent elective PCI. The major adverse cardiac and cerebral event (MACCE) and clinical prognosis in the occurrence and long-term outcome were observed. Results The successful PCI rate was 96.0%, the success rate of treatment with targeted lesion vessels was 95.6%(151/158)，and it occurred in 15 cases of MACCE during the follow-up period. Conclusion PCI of octogenarians with ACS is effective with high procedure success rate and low MACCE, it can improve their prognosis in the clinical outcome. 　　[Key words] Acute coronary syndrome; Percutaneous coronary; Interventional therapy; Clinic analysis 　　急性冠脉综合征（acute coronary syndromes，ACS）是一组因冠状动脉斑块破裂、血栓或血管痉挛导致急性心肌缺血的临床综合征，包括ST段、非ST段抬高性心肌梗死和不稳定心绞痛等，是心内科急症之一[1]。经皮冠状动脉介入（percutaneous coronary intervention，PCI）是目前ACS治疗的主要方法，但高龄人群的病理生理特征往往使其同时合并多支血管病变或复杂病变，国外相关研究表明[2]，与非高龄冠心病患者行PCI术比较，高龄患者PCI术后主要不良心脏事件发生率相对较多。本研究拟通过回顾性分析100例高龄ACS患者介入治疗转归预后的临床资料，进一步探讨高龄冠心病人群的救治方案。现报道如下： 　　1 资料与方法 　　1.1 一般资料 　　选择2008年7月～2010年7月某院收治的ACS患者100例，其中，男68例，女32例，年龄75～81（76.0±5.2）岁，所选病例均经冠状动脉造影证实有介入治疗指征。参照ACC/AHA急性冠状动脉综合征的诊断指南，100例ACS患者可分为