陈焱,赵帅,杨丽,朱伯达,马炳琦,王嘉仪,邹一鸣,胡文涛,李成祥,廉坤,韩鹏

• 1:中国人民解放军空军军医大学第一附属医院心血管内科
• 2:中国人民解放军海军第九七一医院心血管内科
• 3:中国人民解放军西部战区空军医院心血管内科
• 4:中国人民解放军空军航空大学初级飞行训练基地

摘要(Abstract)：

目的 探讨冠状动脉慢性完全闭塞（CTO）病变经皮冠状动脉介入治疗（PCI）对老年多支CTO病变患者症状和生活质量的影响。方法 连续纳入2018年4月至2021年4月于中国人民解放军空军军医大学第一附属医院成功接受择期CTO-PCI的多支CTO病变患者284例，并根据年龄分为老年组（>65岁，106例）和非老年组（≤65岁，178例）。收集两组患者的术前资料、术前生活质量评估、冠状动脉造影结果和术中数据、院内并发症及1个月和1年的随访数据。通过分析患者CTO-PCI术后1个月和1年后欧洲五维健康量表（EQ-5D）、生命质量SF-12量表和西雅图心绞痛量表（SAQ）分数与主要不良心血管事件（MACE）发生情况，评估成功CTO-PCI对老年多支CTO病变患者的生活质量和症状的影响。结果 老年组与非老年组成功行CTO-PCI术后1个月MACE发生率分别为15.53%和10.98%，术后1年MACE发生率分别为23.71%和15.95%，差异均无统计学意义（均P>0.05）。两组患者术后1个月和1年SAQ量表的心绞痛稳定性（SAQ-AS）、心绞痛频率（SAQ-AF）、治疗满意度（SAQ-TS）明显改善，老年组术后1个月和1年SAQ量表的疾病感知（SAQ-DP）也明显改善，差异均有统计学意义（均P<0.05）。老年组术后1年SAQ量表的身体限制（SAQ-PL）[0（–15.56,11.11）比2.22（–8.89,13.33）,P=0.021]和SAQ-AS[12.50(0,50.00)比25.00(0,50.00),P=0.019]评分变化量小于非老年组，差异均有统计学意义。两组患者术后1个月和1年EQ-5D评分较术前均显著升高（均P<0.05），但两组间比较差异均无统计学意义（均P>0.05）。两组患者术后1个月和1年SF-12量表的身体功能成分得分（PCS）均较术前升高（均P<0.001），老年组术后1个月的心理功能成分得分（MCS）也较术前升高[（55.91±3.99）比（53.76±6.68）,P=0.005]，差异均有统计学意义。结论 成功的CTO-PCI可以显著缓解老年多支CTO病变患者症状并改善其生活质量，对老年多支CTO病变患者及时行CTO-PCI是相对安全且必要的。

关键词(KeyWords)： 慢性完全闭塞;多支闭塞;老年;临床症状;生活质量

Abstract:

Keywords:

基金项目(Foundation): 空军军医大学临床研究项目（2022LC2208）;空军军医大学教学改革研究项目（KJJYDXYB015）;; 西京医院临床新技术新业务项目（XJGX15Y39）

作者(Author): 陈焱,赵帅,杨丽,朱伯达,马炳琦,王嘉仪,邹一鸣,胡文涛,李成祥,廉坤,韩鹏

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