高龄患者冠状动脉介入治疗中两种支架术后出血并发症的比较

Comparison of hemorrhage between two stents of percutaneous coronary intervention in elderly patients

摘要: 目的比较高龄患者在药物洗脱支架(DES)和金属裸支架(BMS)植入后出血并发症的发生率，探讨高龄患者支架的选择问题。方法 2004年5月～2006年5月收治经皮冠脉介入治疗(PCI)年龄>75岁的冠心病患者360例，其中DES植入196例， BMS植入164例。术后按常规服药，随访1年。术后1，3，6及12个月复查血、尿常规、粪隐血，观察有无出血情况。结果两组患者在性别、年龄、并发症及病变程度方面无明显差异。1年内DES组47例出现出血，出血并发症明显增多，而BMS组出血13例，且两组比较有统计学差异(P<0.01)。结论高龄患者DES植入术后出血率增加。

Abstract: AIM To explore the choice of stents by comparing the hemorrhage following drug-eluting stents (DES) or bare-metal stents (BMS) in patients beyond the age of 75. METHODS A total of 360 (196 DES and 164 BMS) consecutive patients undergoing DES or BMS from 2004 to 2006 were included in the study. The subjects took medicine as directed and routine laboratory examinations were conducted during the one-year follow-up. RESULTS No significant difference was found in gender, age or complications between the two groups. Hemorrhage was found in 47 patients with DES but only in 13 with BMS(P<0.01). CONCLUSION DES implantation in patients beyond the age of 75 has a higher rate of hemorrhage.