侯春霞, 杨菲菲, 熊敏俊, 郭马特, 马永江, 张丽伟, 陈强. 超高龄冠心病患者冠状动脉介入术后的随访研究[J]. 心脏杂志, 2022, 34(5): 537-540, 551. DOI: 10.12125/j.chj.202109074
    引用本文: 侯春霞, 杨菲菲, 熊敏俊, 郭马特, 马永江, 张丽伟, 陈强. 超高龄冠心病患者冠状动脉介入术后的随访研究[J]. 心脏杂志, 2022, 34(5): 537-540, 551. DOI: 10.12125/j.chj.202109074
    Chun-xia HOU, Fei-fei YANG, Min-jun XIONG, Ma-te GUO, Yong-jiang MA, Li-wei ZHANG, Qiang CHEN. Follow-up study of clinical outcomes of percutaneous coronary intervention in over-aged patients[J]. Chinese Heart Journal, 2022, 34(5): 537-540, 551. DOI: 10.12125/j.chj.202109074
    Citation: Chun-xia HOU, Fei-fei YANG, Min-jun XIONG, Ma-te GUO, Yong-jiang MA, Li-wei ZHANG, Qiang CHEN. Follow-up study of clinical outcomes of percutaneous coronary intervention in over-aged patients[J]. Chinese Heart Journal, 2022, 34(5): 537-540, 551. DOI: 10.12125/j.chj.202109074

    超高龄冠心病患者冠状动脉介入术后的随访研究

    Follow-up study of clinical outcomes of percutaneous coronary intervention in over-aged patients

    • 摘要:
        目的  分析接受经皮冠状动脉介入(PCI)治疗的超高龄患者的随访资料,探讨影响患者预后的危险因素。
        方法  入选行冠脉支架植入术1年以上并接受冠状动脉造影复查的患者共397例,根据年龄是否≥80岁分为超高龄组(n=67)与对照组(n=330)。比较两组的临床资料特点、晚期支架内再狭窄率以及超声心动指标,对患者进行长期随访,分析不良心血管事件的发生率。采用Logistic回归分析影响预后的危险因素。
        结果  超高龄组患者平均年龄(83 ± 3)岁,明显高于对照组患者(63 ± 9)岁 (P<0.01)。超高龄组患者晚期支架内再狭窄率为40%,对照组患者为32%,组间差异无统计学意义。与对照组患者比较,超高龄组患者白细胞(P<0.05)、血红蛋白含量(P<0.01)、总三碘甲腺原氨酸(T3)(P<0.01)以及游离T3P<0.01)的水平均偏低;而高血压(P<0.05)及血清肌酐(P<0.01)水平偏高;与对照组患者超声心动结果比较,超高龄组患者室间隔厚度偏大,左室舒张末径偏小,差异有统计学意义(P<0.05)。两组患者射血分数无统计学差异。随访期间,超高龄组的不良事件发生率比对照组显著增加(P<0.01),两组不良事件的构成比例无显著差异;年龄是影响PCI患者预后的独立危险因素。
        结论  超高龄PCI患者合并其他系统疾病更常见,远期预后更差。年龄是影响PCI手术远期预后的独立危险因素。

       

      Abstract:
        AIM  To study the clinical features and long-term prognosis of over-aged patients undergoing percutaneous coronary intervention (PCI) and to discuss the risk factors for the prognosis.
        METHODS  Included for this study were 397 patients who underwent PCI over one year and received coronary angiography during the admission. The patients were divided by age into over-aged group (≥80 years) and control group (<80 years). Clinical characteristics and echocardiographic data were examined and long-term clinical follow-up was carried out to investigate the rates of adverse events. Logistic regression analysis was performed to analyzed the risk factors for the prognosis.
        RESULTS  The average age of patients in the super elderly group was (83 ± 3) years, which was significantly higher than that in the control group (63 ± 9) (P<0.01). The late in stent restenosis rate was 40% in the super elderly group and 32% in the control group. There was no significant difference between the two groups. Compared with the control group, the levels of leukocyte (P<0.05), hemoglobin (P<0.01), total triiodothyronine (T3) (P<0.01) and free T3 (P<0.01) in the super elderly group were lower; The levels of hypertension (P<0.05) and serum creatinine (P<0.01) were higher; Compared with the results of echocardiography in the control group, the thickness of ventricular septum in the super elderly group was larger and the left ventricular end diastolic diameter was smaller, the difference was statistically significant (P<0.05). There was no significant difference in ejection fraction between the two groups. There was no significant difference in the incidence of adverse events between the two groups (P<0.01); Age is an independent risk factor for the prognosis of PCI patients.
        CONCLUSION  Over-aged patients undergoing PCI might have higher rates of hypertension, renal dysfunction and thyroid dysfunction. The long-term prognosis is poorer. Age is the independent risk factor for the adverse prognosis.

       

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