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中国人民解放军总医院
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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
电话:010-66936756
传真:010-66936756
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
张文沛,杨涛,续慧民,郝斌.老年女性动脉硬化闭塞症的特点及腔内治疗效果评价[J].中华老年多器官疾病杂志,2018,17(8):588~591
老年女性动脉硬化闭塞症的特点及腔内治疗效果评价
Characteristics of arteriosclerosis obliterans in elderly women and assessment of endovascular treatment
投稿时间:2018-05-03  修订日期:2018-06-20
DOI:10.11915/j.issn.1671-5403.2018.08.134
中文关键词:  老年女性;动脉硬化闭塞;腔内治疗;特点;预后
英文关键词:elderly women; arteriosclerosis occlusion; endovascular treatment; characteristics; prognosis
基金项目:
作者单位E-mail
张文沛 山西医学科学院山西大医院血管外科,太原 030032  
杨涛 山西医学科学院山西大医院血管外科,太原 030032  
续慧民 山西医学科学院山西大医院血管外科,太原 030032  
郝斌 山西医学科学院山西大医院血管外科,太原 030032 haobin63@163.com 
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中文摘要:
      目的 探讨老年女性动脉硬化闭塞症患者的特点及腔内治疗的预后情况。方法 回顾性总结2015年3月至2016年3月山西大医院血管外科收治的106例下肢动脉硬化闭塞症老年患者的临床资料。其中男性54例,年龄60~89(68.3±13.4)岁;女性52例,年龄59~90(77.3±7.7)岁。全部患者接受下肢动脉腔内治疗,比较男性与女性之间的一般资料及术后随访情况,总结分析女性患者患病因素及腔内治疗效果评价。采用SPSS 22.0统计学软件进行分析。计数资料比较采用χ2检验。 结果 全部患者进行腔内手术并随访,手术成功率99.1%(1例男性多节段病变未开通),随访率94.3%。与男性患者相比,老年女性的发病年龄更大,吸烟者少,合并高血压患者多,且股动脉以远病变患者比例更大,病变程度更重(均P<0.05)。围手术期严重并发症4例(3.85%),其中2例心肌梗死均为女性。随访期内死亡3例(男性2例,女性1例),截肢5例(男性3例,女性2例),并发心脑血管事件11例(男性2例,女性9例),支架内再狭窄17例(男性13例,女性4例)。比较两性患者的随访数据,结果显示,腔内治疗后老年女性患者再栓塞率低于男性(χ2=5.085,P=0.024),但并发心脑血管事件发生率显著高于男性(χ2=5.271,P=0.022)。结论 老年女性下肢动脉硬化患者平均发病年龄更大,且多合并高血压病,但吸烟者明显少于男性,病变程度更重。腔内治疗后老年女性患者再栓塞率低于男性,但并发心脑血管事件发生率明显升高。
英文摘要:
      Objective To investigate the characteristics and prognosis of arteriosclerosis obliterans in the elderly women. Methods A retrospective analysis was performed of 106 elderly patients (54 males and 52 females) from March 2015 to March 2016 with arteriosclerosis obliterans. The 54 male patients were 60-89 (68.3±13.4) years old, and 52 female patients 59-90 (77.3±7.7) years old. All the patients received endovascular treatment of lower extremity arteries. The two gender groups were compared in terms of the general data and postoperative follow-up, and the female patients were analyzed for the prevalence factors and efficacy of endovascular treatment. SPSS statistics 22.0 was used for data analysis, and Chi-square test for comparison of enumeration data. Results All patients underwent endoluminal surgery and were followed up, with a success rate of 99.1% (failed recanalization in 1 male patient with multi-segment lesions) and a follow-up rate of 94.3%. The female group were significantly advanced in age (P<0.05), with fewer smokers (P<0.05), more complicated with hypertension (P<0.05), greater proportion with distant femoral lesions (P<0.05) and more severe lesions (P<0.05). Perioperative complications occurred in 4 serious patients (3.85%), 2 of whom were female and had myocardial infarction. During the follow-up, in-stent restenosis occurred in 17 patients (13 males and 4 females) and, 3 (2 males and 1 female) died, 5 (3 males and 2 females) amputated. Cardiovascular and cerebrovascular events were reported in 11 patients (2 males and 9 females). Conclusion Compared with the males, the elderly females have a higher average age of onset of lower extremity arteriosclerosis, a higher proportion of concomitant hypertension, a significant smaller number of smokers, and more severe lesions. The elderly females show a lower rate of re-embolism after endovascular treatment than the males, but the incidence of concurrent cardiovascular and cerebrovascular events is significantly higher.
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