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目的:探讨高龄女性冠心病患者的冠状动脉造影介入治疗特点及近远期的疗效。方法:在2004年1月~2006年3月行冠状动脉介入治疗的患者中,入选183例女性患者,根据年龄分为高龄女性组(年龄≥75岁,48例)和非高龄女性组(年龄<75岁,135例),同时入选同期77例高龄男性组患者作为对照。回顾性分析这些患者的临床及冠状动脉病变特点、即刻手术成功率和近远期主要心脏不良事件。结果:与非高龄女性组相比,高龄女性组表现为更多的危险因素及基础疾病丛集(P<0.05),多见冠状动脉多支病变及复杂病变(P<0.01),住院期间及远期随访严重心脏不良事件发生率高。与高龄男性组相比,高龄女性也表现为更多的危险因素及基础疾病丛集(P<0.05),尽管冠状动脉病变分布及严重程度相似(P>0.05),但住院期间及远期随访严重心脏不良事件发生率高(P<0.05)。高龄女性与高龄男性患者的总病死率差异无统计学意义,在校正了基线特征后,女性患者的危险降低(OR=0.82,95%CI0.675~0.989,P<0.05)。结论:高龄女性冠心病患者常伴有多种危险因素及基础疾病,冠状动脉病变严重复杂,近远期主要心脏不良事件发生率高,总病死率与高龄男性患者差异无统计学意义。
Objective: To investigate the characteristics of coronary interventional therapy in elderly women with coronary heart disease and the curative effect in short-term and long-term. Methods: From January 2004 to March 2006, 183 women undergoing coronary intervention were enrolled. According to their age, they were divided into the elderly female group (age≥75 years, 48 cases) and the non-elderly female group (age <75 years old, 135 cases), at the same time selected 77 cases of elderly men in the same period as a control group. The clinical and coronary characteristics of these patients were retrospectively analyzed. The immediate success rate of surgery and major adverse cardiac events in the near future were analyzed retrospectively. Results: Compared with non-elderly women group, the elderly women group showed more risk factors and underlying disease cluster (P <0.05), multiple coronary lesions and complex lesions (P <0.01), hospitalization period and far The high incidence of serious cardiac adverse events during follow-up. Compared with the elderly men, older women also showed more risk factors and underlying disease clusters (P <0.05). Although the distribution and severity of coronary lesions were similar (P> 0.05), the duration of hospitalization and long-term follow-up The incidence of adverse cardiac events was high (P <0.05). There was no significant difference in the overall mortality rate between the elderly women and the elderly men. After adjusting for the baseline characteristics, the risk of female patients decreased (OR = 0.82, 95% CI 0.675-0.989, P <0.05). Conclusion: The elderly women with coronary heart disease are often accompanied by a variety of risk factors and underlying diseases. The severity of coronary artery disease is serious and complicated. The incidence of major adverse cardiac events in the short and long term is high. There is no significant difference between the overall mortality and the elderly men.