何晓全,张婧薇,范琰,陈夏欢,黄波,王禹川,刘梅林

• 1:北京大学第一医院老年内科

摘要(Abstract)：

目的探讨老年患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后再次血运重建相关危险因素。方法入选2004年1月至2015年12月北京大学第一医院行PCI治疗、年龄≥60岁的患者315例,年龄60~96(72.89±7.80)岁,中位随访时间为62个月。根据部位不同将所有再次血运重建患者分为靶病变再次血运重建(target lesion repeat revascularization,TLR)组和非靶病变血运重(non-target lesion revascularization,non-TLR)组,分别与未发生再次血运重建组比较并进行Logistic回归分析。结果所有入选患者中共104例(33.0%)发生再次冠状动脉血运重建,其中TLR组和non-TLR组分别为32例(10.2%)和72例(22.9%)。多因素回归分析显示,糖尿病(OR 4.560,95%CI 1.935~10.745,P=0.001)和平均置入支架总数(OR 1.549,95%CI 1.049~2.288,P=0.028)与TLR相关,年龄(OR 0.941,95%CI 0.904~0.979,P=0.003)、低密度脂蛋白胆固醇(LDL-C)降幅(OR 2.512,95%CI 1.562~3.987,P<0.001)、分叉病变比例(OR 2.238,95%CI 1.197~4.173,P=0.014)和残余病变SYNTAX积分(rSS)(OR 1.068,95%CI 1.019~1.109,P=0.004)是non-TLR的独立危险因素。结论糖尿病和支架置入数是老年患者PCI术后TLR的相关危险因素,平均年龄小,LDL-C降幅小、分叉病变和rSS偏高与老年患者PCI术后non-TLR相关。

关键词(KeyWords)： 老年;经皮冠状动脉介入治疗;再次血运重建;危险因素

Abstract:

Keywords:

基金项目(Foundation): 中国医药卫生事业发展基金会资助(20080717)

作者(Author): 何晓全,张婧薇,范琰,陈夏欢,黄波,王禹川,刘梅林

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