高龄冠心病患者择期冠状动脉支架置入术的临床特点及随访结果Clinical characteristics and long-term results of elective coronary stenting in octogenarians with coronary artery disease
秦学文,李崇剑,李晓东,高润霖,陈纪林,杨跃进,徐波,乔树宾,姚民,刘海波,陈珏,吴永健,袁晋青
摘要(Abstract)：
目的评价高龄冠心病患者择期冠状动脉支架置入术的临床特点和长期疗效。方法2000年1月至2003年12月经冠状动脉造影证实的80岁以上的冠心病患者84例,分为支架组45例与药物组39例,比较两组的临床特点、住院期间疗效及长期随访结果。结果两组患者性别、年龄等基本临床特征差异无统计学意义,支架组急性心肌梗死患者比例较药物组明显高(40·0%比17·9%,P<0·05)。两组患者病变血管支数、病变类型差异均无统计学意义。支架组置入72枚支架,每例患者平均置入支架1·6枚;支架平均长度18·48±5·15mm,支架平均直径3·14±0·34mm。操作成功率、支架成功率及临床成功率分别为88·9%,95·6%和93·3%。平均随访时间(24·0±11·5)个月,随访率92·86%。随访期间支架组与药物组各发生心源性死亡1例;支架组主要心脏不良事件(MACE)和心绞痛复发的发生时间显著迟于药物组(14·3±5·6个月比9·1±6·0个月,P<0·05);支架组随访期间无MACE和心绞痛复发的生存率显著高于药物组。结论高龄冠心病患者择期支架置入术成功率较高,与单纯的药物组比较,可提高远期无MACE和心绞痛复发的生存率。
关键词(KeyWords)： 冠状动脉疾病;支架;预后
基金项目(Foundation):
作者(Author): 秦学文,李崇剑,李晓东,高润霖,陈纪林,杨跃进,徐波,乔树宾,姚民,刘海波,陈珏,吴永健,袁晋青
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