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目的评价经皮冠状动脉介入治疗(percutaneus coronary intervention,PCI)老年冠心病患者冠状动脉慢性闭塞病变(chronic total occlusion,CTO)的可行性及安全性。方法回顾性分析我院2005年3月~2009年8月冠状动脉造影示慢性闭塞病变的患者125例,按年龄分组,对照观察老年组[年龄≥60岁,平均(74.6±10.7)岁]56例及中青年组[年龄<60岁,平均(52.3±12.6)岁]69例临床特征、冠状动脉造影所见病变特点、闭塞血管开通率、并发症发生率、随访主要心血管事件及病死率。结果老年组女性患者比例、高血压病患病率、脑血管病及其他疾病患病率高于中青年组,闭塞时间长于中青年组,合并2支以上血管闭塞率较中青年组高,差异均有统计学意义(P<0.05),两组闭塞病变血管支数及部位、平均造影剂用量、应用导丝数量及球囊数量、支架植入数、闭塞病变开通率、并发症发生率、随访主要心血管事件及病死率差异均无统计学意义(P>0.05)。结论老年冠心病冠状动脉CTO患者行PCI安全可行,手术并发症少。
Objective To evaluate the feasibility and safety of chronic total occlusion (CTO) in elderly patients with coronary artery disease undergoing percutaneus coronary intervention (PCI). Methods A retrospective analysis of 125 patients with chronic occlusive disease undergoing coronary angiography from March 2005 to August 2009 in our hospital was performed. The elderly group (age ≥60 years, mean (74.6 ± 10.7) years) 56 Cases and young group [age <60 years, mean (52.3 ± 12.6) years old] 69 cases of clinical features, coronary angiography lesion characteristics, occlusion vessel opening rate, complication rate, follow-up of major cardiovascular events and mortality . Results The prevalence of female patients, hypertension, cerebrovascular disease and other diseases in the elderly group was higher than that in the middle-aged and young adults. The occlusion time was longer in the elderly group than in the middle-aged group. The rates of vascular occlusion with more than two branches in the elderly group were higher than those in the middle- (P <0.05). The number of vessel and site of occlusion, the average amount of contrast medium, the number of guide wire and balloon, the number of stent implantation, the occlusion lesion opening rate, the complication rate, Follow-up of major cardiovascular events and mortality did not differ significantly (P> 0.05). Conclusion Elderly patients with coronary artery CTO coronary artery coronary artery safe and feasible, fewer surgical complications.