余晓凡,李晶,王贺阳,赵公双,陈玉山,杨宇进,韩雅玲,李毅

• 1:沈阳军区总医院心内科
• 2:安徽省立医院心内科

摘要(Abstract)：

目的评价老年非ST段抬高急性冠状动脉综合征(non-ST-segment elevation acute coronary syndrome,NSTE-ACS)患者介入治疗术后近期与远期预后是否存在性别差异。方法连续纳入2008年12月至2012年1月在沈阳军区总医院行经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)、年龄≥60岁的NSTE-ACS患者3539例,按照性别分为男性组2323例和女性组1216例。比较不同性别间的PCI成功率、术后30 d和3年的主要不良心血管事件[MACE,包括心源性死亡、心肌梗死、靶血管血运重建(target vessel revascularization,TVR)、支架内血栓]发生情况。结果女性组和男性组的PCI成功率比较,差异无统计学意义(98.1%比97.8%,P=0.604)。术后30 d,女性组MACE的发生率显著高于男性组(1.5%比0.8%,P=0.047),其中心源性死亡和心肌梗死发生率明显高于老年男性组(0.7%比0.1%,P=0.017;0.9%比0.3%,P=0.030),支架内血栓和TVR发生率与男性组相比,差异均无统计学意义(均P>0.05)。术后3年,女性组和男性组MACE发生率的差异无统计学意义(9.7%比10.9%,P=0.257),其中心源性死亡、心肌梗死、TVR、支架内血栓在两组间分别比较,差异均无统计学意义(均P>0.05)。校正基线不均衡因素后,术后30 d女性组MACE(OR 2.158,95%CI 1.036~4.497,P=0.040)、心源性死亡(OR 6.004,95%CI 1.576~22.869,P=0.009)发生率均高于男性组,而术后3年MACE发生率在两组间比较,差异无统计学意义(OR 0.860,95%CI 0.677~1.091,P=0.214)。结论与老年男性NSTE-ACS患者相比,老年女性患者PCI术后近期预后较差,但远期预后与男性相当。

关键词(KeyWords)： 非ST段抬高急性冠状动脉综合征;经皮冠状动脉介入治疗;老年;性别差异

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 余晓凡,李晶,王贺阳,赵公双,陈玉山,杨宇进,韩雅玲,李毅

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