论文部分内容阅读
目的观察药物洗脱支架(drug-eluting stent,DES)治疗老年无保护左主干(unprotected left main artery,ULM)冠状动脉病变长期临床疗效。资料与方法分析老年ULM病变冠心病患者的临床特点,并随访置入DES后远期主要心脏血管事件(major adverse cardiac and cerebral events,MACCE)。结果老年组冠状动脉病变SYN-TAX评分更高(P=0.040),慢性闭塞病变(chronic total occlusion,CTO)比例和合并2支病变以上比例明显高于中青年组(P<0.05)。老年组发生MACCE共21例,中青年组仅17例,差异有显著统计学意义(Log rank,P=0.034)。两组远期死亡、心肌梗死、再次血运重建类似。合并2型糖尿病的老年ULM患者MACCE明显高于单纯老年ULM(Log rank,P=0.037)。结论老年ULM患者冠状动脉病变严重,DES治疗后远期疗效可以接受;2型糖尿病是老年ULM患者MACCE的预测因子。
Objective To observe the long-term clinical efficacy of drug-eluting stent (DES) in the treatment of unprotected left main artery (ULM) coronary artery disease. Materials and Methods The clinical features of elderly patients with coronary artery disease (ULM) were analyzed and followed up for major adverse cardiac and cerebral events (MACCE). Results The SYN-TAX scores of coronary artery lesions in the elderly group were higher (P = 0.040), the ratio of chronic total occlusion (CTO) and the 2 lesions were significantly higher than those in the young group (P <0.05). There were 21 cases of MACCE in the elderly group and 17 cases in the middle-aged and young group, the difference was statistically significant (Log rank, P = 0.034). Long-term death of both groups, myocardial infarction, again similar to the revascularization. The MACCE of elderly patients with type 2 diabetes mellitus was significantly higher than that of elderly patients with ULM (Log rank, P = 0.037). Conclusion Elderly patients with severe coronary artery disease ULM, long-term efficacy after DES treatment acceptable; type 2 diabetes mellitus is a predictor of MACCE in elderly patients with ULM.