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目的 研究冠脉残余病变对老年冠心病患者经皮冠状动脉介入(PCI)治疗术后发生再次血运重建的影响.方法 入选我院老年科行冠状动脉支架植入的≥60岁患者315例.中位随访时间为62(65±42)个月.应用SYN-TAX积分系统定量判定PCI后残余病变,即残余SYNTAX积分(Residual SYNTAX score,rSS),简单线性回归分析rSS与基线SYNTAX积分(baseline SYNTAX score,bSS)的相关性.比较所有发生再次血运重建患者与未发生再次血运重建患者的基本资料,逐步回归分析rSS与总体血运重建的相关性.根据rSS水平进行3分组,即完全血运重建(Complete revascularization,CR)组(rSS =0),rSS低分组(0＜rSS≤8)和rSS高分组(rSS ＞8),比较不同rSS分组间PCI后再次血运重建累积发生率的差异.结果 老年冠心病患者rSS与bSS呈直线相关性,并且rSS是老年冠心病患者PCI后发生再次血运重建的相关危险因素.不同rSS分组间发生再次血运重建的累积发生率存在统计学差异(P＜0.01),rSS高分组与rSS低分组和CR组存在显著差异(均P＜0.01),而rSS低分组与CR组无统计学差异.结论 老年冠心病患者PCI术后残余病变是老年冠心病患者PCI后再次血运重建的危险因素,残余病变较重患者(rSS＞8)比残余病变较轻(0＜rSS≤8)和CR(rSS=0)患者再次血运重建的风险增加.“,”AIM To analyze the effect of residual coronary artery lesions on repeat revascularization after PCI in elderly patients with coronary heart disease.METHODS A total of 315 patients at Peking University First Hospital Geriatrics were enrolled,aged 60-99 (72.89 ± 7.80) years.The median follow-up was 62 months.The SYNTA score system was utilized to quantitatively determine residual lesions after PCI as residual SYNTAX score (rSS).The correlation between rSS and baseline SYNTAX score (bSS) was analyzed by simple linear regression analysis.Data of patients experiencing repeat revascularization and those who did not experience repeat revascularization were compared.The correlation between rSS and total revascularization was analyzed by stepwise regression analysis.All patients were grouped according to levels of rSS as CR group (rSS =0),rSS lower group (rSS≥8 but ＞0) and rSS higher group (r ＞8).The cumulative incidence of repeat revascularization after PCI was compared between different groups.RESULTS RSS was linearly correlated with bSS and was a risk factor associated with repeat revascularization in elderly patients with coronary artery disease after PCI.There were statistical differences between rSS groups in the cumulative incidence of revascularization (P ＜ 0.01).Comparison revealed that the higher rSS group was significantly different from the lower rSS group (P ＜0.01) and the CR group (P ＜0.01).There were no significant differences between lower rSS and CR groups.CONCLUSION Residual lesions are a risk factor for repeat revasctdarization after PCI in elderly patients with coronary heart disease and the risk of repeat revascularization in patients with heavier residual disease (rSS ＞ 8) was significantly higher than that with less residual disease (0 ＜rSS≤8) and CR patients (rSS =0).