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目的探讨老年冠心病患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后1 a预后及相关影响因素。方法前瞻性纳入2010年1月—2014年6月在重庆市长寿区人民医院成功行PCI的老年(年龄>65岁)冠心病患者128例,随访其术后1 a死亡及主要不良心血管事件发生情况,采用COX比例风险回归模型筛选影响老年冠心病患者预后的主要影响因素。结果 PCI术后患者共128例,年龄在65~77岁之间,平均(75.7±6.8)岁;男性患者73例,占57.0%。术后1 a患者随访率为98.4%,术后1 a一级终点事件发生率为9.5%,二级终点事件发生率为11.9%。多因素COX比例风险回归模型分析结果显示,高血压(HR=1.619,95%CI:1.047~2.505,P=0.022)、不稳定型心绞痛(HR=2.905,95%CI:2.222~3.799,P=0.007)是术后1 a不良心血管事件发生风险升高的独立危险因素,而使用β-受体阻滞剂(HR=0.117,95%CI:0.051~0.276,P<0.01)和使用血管紧张素转酶抑制剂/血管紧张素Ⅱ受体拮抗剂(ACEI/ARB)(HR=0.379,95%CI:0.158~0.911,P=0.003)则是术后1 a不良心血管事件发生风险降低的独立预测因素。结论加强危险因素控制,加强PCI术后充分药物治疗,可在PCI手术基础上改善老年冠心病患者1 a的预后。
Objective To investigate the prognosis of elderly patients with coronary artery disease percutaneous coronary intervention (percutaneous coronary intervention, PCI 1 a postoperative prognosis and related factors. Methods A total of 128 elderly patients (aged> 65 years) with coronary heart disease who underwent PCI in Changshou District People’s Hospital of Chongqing from January 2010 to June 2014 were prospectively included. The patients were followed up for 1 year and major adverse cardiovascular events Occurrence, the use of COX proportional hazards regression model screening of elderly patients with coronary heart disease affect the prognosis of the main factors. Results A total of 128 patients undergoing PCI were aged 65 to 77 years (mean, 75.7 ± 6.8) years; 73 males (57.0%) were male. The follow-up rate was 98.4% at 1 year after operation. The incidence of first-degree end-point events at 1 year after operation was 9.5%, and the second-end event rate was 11.9%. Multivariate COX proportional hazards regression model analysis showed that hypertension (HR = 1.619, 95% CI: 1.047-2.505, P = 0.022), unstable angina (HR = 2.905, 95% CI: 2.222-3.799, P = 0.007) was an independent risk factor for the increased risk of adverse cardiovascular events at 1 year after surgery, but β-blockers (HR = 0.117, 95% CI: 0.051-0.276, P <0.01) ACE inhibitors / angiotensin II receptor blockers (ACEI / ARB) (HR = 0.379, 95% CI: 0.158-0.911, P = 0.003) were associated with a reduced risk of adverse cardiovascular events one year after surgery Independent predictors. Conclusion To strengthen the control of risk factors and strengthen the full medical treatment after PCI, we can improve the prognosis of elderly patients with coronary artery disease for 1 year on the basis of PCI.