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目的探讨75岁以上老年冠心病患者冠状动脉病变特点及其介入治疗(PCI)的安全性。方法回顾性分析2005年3月至2006年3月间43例行PC I的患者,统计、分析和比较≥75岁老年组与≤74岁年龄组的临床及冠脉病变特点,成功置入支架、不宜或未能置入支架而需外科搭桥以及术中、术后发生不良事件的比例。结果两组合并高血压、高血脂、糖尿病的比例基本相似,但≥75岁老年组(20例)患陈旧性心肌梗死、左心功能不全、陈旧性脑梗死和肾功能减退的比例[分别为25%比13%(P<0.05)、35%比8.7%(P<0.01)、25%比13%,、20%比4.3%(P<0.05)]高于≤74岁年龄组(23例);两组冠脉造影病变阳性率大致相似,但≥75岁老年组的冠脉病变多为多支病变、复杂病变(两组比较分别为50%比17.6%、74.3%比51.6%,(P<0.01),成功置入支架的比例前者显著低于后者(34.3%比58.1%,P<0.01);因多支病变或复杂病变不宜或未能置入支架而需外科搭桥的比例前者显著高于后者(35.7%比17.6%,P<0.01);PC I术中、术后不良事件发生率前者显著高于后者(30%比0,P<0.01)。结论≥75岁老年冠心病患者常有心、脑、肾功能减退,其冠脉病变的特点是常为多支和复杂病变,PC I术中、术后不良事件的发生率高。
Objective To investigate the characteristics of coronary artery lesions in elderly patients over 75 years of age and its interventional therapy (PCI). Methods The clinical data of 43 patients with PC I from March 2005 to March 2006 were analyzed retrospectively. The clinical and coronary characteristics of patients aged ≥75 years and ≤74 years were analyzed. , Should not be placed in stents or unsuccessful surgical bypass and postoperative incidence of adverse events. Results The proportions of hypertension, hyperlipidemia and diabetes were similar in both groups, but the proportion of old myocardial infarction, left ventricular dysfunction, old cerebral infarction and renal dysfunction in ≥75 years old group (20 cases) were 25% vs 13% (P <0.05), 35% vs 8.7% (P <0.01), 25% vs 13%, 20% vs 4.3% (P <0.05) ). The positive rates of coronary angiography were similar between the two groups, but the multi-vessel disease and complex lesions were more common in the 75-year-old group (50% vs 17.6%, 74.3% vs 51.6% (P <0.01). The former was significantly lower than the latter (34.3% vs 58.1%, P <0.01). The proportion of patients who had unsuccessful or unsuccessful stenting due to multi-vessel disease or stent placement (35.7% vs. 17.6%, P <0.01). The incidence of postoperative adverse events in PC I patients was significantly higher than that in the latter (30% vs 0, P <0.01) Patients with coronary heart disease often have heart, brain, kidney dysfunction, coronary artery lesions are often characterized by multiple branches and complex lesions, PC I intraoperative and postoperative adverse events were high incidence.