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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
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E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
王崇振,王选琦,黄莉.不同血运重建策略对老年非ST段抬高型急性冠脉综合征合并多支血管病变患者预后的影响[J].中华老年多器官疾病杂志,2017,16(12):934~938
不同血运重建策略对老年非ST段抬高型急性冠脉综合征合并多支血管病变患者预后的影响
Prognostic impact of different revascularization strategies in the elderly with non-ST elevation acute coronary syndrome complicated with multivessel disease
投稿时间:2017-07-12  修订日期:2017-07-29
DOI:10.11915/j.issn.1671-5403.2017.12.217
中文关键词:  急性冠状动脉综合征;经皮冠状动脉介入治疗;多支血管病变;完全血运重建;主要不良心血管事件
英文关键词:acute coronary syndromes; percutaneous coronary intervention; multivessel disease; complete revascularization; major adverse cardiovascular events
基金项目:
作者单位E-mail
王崇振 陕西省第四人民医院心血管内科,西安 710043  
王选琦 陕西省第四人民医院心血管内科,西安 710043  
黄莉 陕西省第四人民医院心血管内科,西安 710043 guoxin829852@163.com 
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中文摘要:
      目的 比较一次与分次经皮冠状动脉介入(PCI)治疗完全血运重建对高龄非ST段抬高型急性冠脉综合征(NSTE-ACS)合并多支血管病变(MVD)患者预后的影响。方法 回顾性分析陕西省第四人民医院心血管内科2016年6月至2017年1月住院治疗的高龄NSTE-ACS合并MVD患者110例,其中男性67例,女性43例,年龄(63.1±8.5)岁。根据完全血运重建策略不同分为一次PCI 组(n=48)和分次PCI组(n=62),比较两组患者PCI治疗、住院期间主要并发症和院内主要不良心血管事件(MACEs)发生率。术后对患者随访6个月,比较两组心功能、心绞痛症状改善情况和MACEs发生率。采用SPSS 19.0统计软件对数据进行分析。组间比较采用t检验或χ2检验。结果 患者术前左室射血分数(LVEF)和院内全球急性冠状动脉事件注册(GRACE)评分差异无统计学意义(P>0.05)。分次PCI组单次造影剂用量明显低于一次PCI组[(180.0±60.0) vs(230.0±70.0)ml,P=0.04],院内MACEs和住院期间主要并发症较一次PCI组显著降低[1.6%(1/62) vs 10.4%(5/48),P=0.04;4.8%(3/62) vs 18.8%(9/48),P=0.02]。随访6个月结果表明分次PCI组较一次PCI组MACEs发生率降低[4.9% (3/61)) vs 17.4%(8/46),P=0.03]。结论 分次PCI完全血运重建安全有效,可能是高龄NSTE-ACS合并MVD患者优先选用的介入治疗策略。
英文摘要:
      Objective To compare the prognostic impact of different revascularization strategies, multi-staged versus single-staged percutaneous coronary intervention (PCI) in the elderly patients with non-ST elevation acute coronary syndrome (NSTE-ACS) complicated with multivessel disease (MVD). Methods A retrospective study was carried out on 110 elderly patients [67 males and 43 females, at an age of (63.1±8.5)years] suffering from NSTE-ACS complicated with MVD who were admitted in our department from June 2016 to January 2017. According to the revascularization, they were divided into single-staged PCI group (n=48) and multi-staged PCI group (n=62). The data of PCI and incidences of complications and major adverse cardiovascular events (MACEs) during hospitalization were observed and compared between the 2 groups. In the end of the 6 months’ follow-up, heart function, relief of angina symptoms, and occurrence of MACEs were compared between the 2 groups. SPSS statistics 19.0 was used to analyze the data. Student’s t test or Chi-square test was adopted for the comparison between the 2 groups. Results There were no significant differences in left ventricular ejection fraction (LVEF) and the in-hospital global registry of acute coronary events (GRACE) risk score before the operation between the 2 groups (P>0.05). The multi-staged PCI group had less usage of contract in coronary angiography [(180.0±60.0) vs (230.0±70.0) ml, P=0.04], and lower incidences of in-hospital MACEs[1.6%(1/62) vs 10.4%(5/48), P=0.04] and complications [4.8%(3/62) vs 18.8%(9/48), P=0.02] when compared with the single-staged PCI group. The occurrence of MACEs was also lower in the multi-staged group than the single-staged group in the end of follow-up[4.9%(3/61) vs17.4%(8/46), P=0.03]. Conclusion Multi-staged PCI is safe and effective for revascularization, and it might be an optimal strategy for the elderly NSTE-ACS patients complicated with MVD.
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