孙静,孙王乐贤,张爱文,张英,王文丰,单伟超,王瑞鹃,李舒承,王晓晓,李春华

• 1:承德医学院附属医院心内科承德市心血管病研究所

摘要(Abstract)：

目的探讨经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)对高龄急性冠状动脉综合征(acute coronary syndrome,ACS)患者预后的影响。方法 2011年11月至2013年9月承德医学院附属医院心内科住院的ACS患者共1640例,连续入选所有符合纳入标准的老年ACS患者374例,根据是否行PCI术分为PCI组(55例)和保守治疗组(319例)。收集患者的临床资料并随访评价预后。结果两组性别构成比,高血压病、2型糖尿病、血脂异常等患病率,吸烟史、既往心力衰竭史、急性肺水肿、心原性休克发生率等比较,差异均无统计学意义(均P>0.05)。两组阿司匹林、血管紧张素转化酶抑制剂或血管紧张素Ⅱ受体拮抗剂、β阻滞剂、他汀等用药比较,差异均无统计学意义(P>0.05)。PCI组氯吡格雷处方率显著高于保守治疗组(P<0.001)。PCI组全因死亡率及主要不良心血管事件发生率低于保守治疗组。Cox多因素模型分析显示,心原性休克、急性肺水肿、既往心力衰竭病史及女性均为老年ACS患者远期预后不良的独立危险因素,HR值依次为8.00、4.61、7.51、3.57(均P<0.05);而PCI是老年ACS患者远期预后的保护因素(HR 0.21,P<0.05)。结论PCI可降低老年ACS患者的全因死亡率与主要不良心血管事件发生率,显著改善预后。

关键词(KeyWords)： 急性冠状动脉综合征;老年人;经皮冠状动脉介入治疗;预后

Abstract:

Keywords:

基金项目(Foundation): 河北省科技厅指令性计划课题项目(13277789D)

作者(Author): 孙静,孙王乐贤,张爱文,张英,王文丰,单伟超,王瑞鹃,李舒承,王晓晓,李春华

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