老年冠心病患者血运重建后远期预后及影响因素分析

摘要

目的 研究老年冠心病患者血运重建后远期预后及影响因素.方法 选择连续就诊的经PCI或冠状动脉旁路移植术治疗的老年冠心病患者223例,根据年龄分为A组(60～69岁)128例,B组(≥70岁)95例,比较2组临床特点及主要心脑血管事件(MACCE)的发生率.结果 与B组比较,A组高脂血症的比例较高(P=0.040),心律失常(P=0.026)和既往脑卒中史比例(P=0.013)较低,病变血管和靶病变数(P=0.002,P=0.013)比例较低.2组总MACCE发生率差异显著(P=0.033),其中靶血管或靶病变血运重建发生率差异显著(P=0.034);A组生存率显著高于B组(P=0.04).年龄、病变血管数和收缩压是MACCE发生的独立预测因素.结论 在老年冠心病中,危险因素随年龄增长明显增多;年龄、病变血管数及较高的收缩压是MACCE发生的独立预测因素.%Objective To study the long-term prognosis of gerontal CHD patients and the influencing factors after revascularization.Methods Two hundred and twenty three patients who underwent PCI or CABG in our center were divided into 2 groups according to age: group A included 128 patients who were aged between 60 and 69,group B included 95 patients who were ≥70 years old.The clinical characteristics, examination results, operation information and the incidence of MACCE were compared between the 2 groups.The major end point was MACCE.Results Incidence of hyperlipoidemia was higher in group A (P = 0.040) ,group B had more risk factors for arrhythmia and stroke,and more target vessels (P ＜ 0.05).After correcting basic difference, the two groups had significant differences in MACCE (P = 0.033).MACCE-free survival rate was higher in group A than in group B(log rank, P = 0.04).Age,the number of diseased vessels and systolic pressure were independent predicting factors for MACCE.Conclusion With increase in age,risk factors for cardiovascular diseases increase.Age,the number of diseased vessels and systolic pressure are independent predicting factors for MACCE.