2018 年第 10 期 第 13 卷

年龄对冠状动脉粥样硬化性心脏病患者药物洗脱支架介入治疗术后主要心脑血管不良事件的影响

Influence of age on major adverse cardio-cerebrovascular events after drug-eluting stent intervention in patients with coronary atherosclerotic heart disease

作者：刘军高传玉寇洁

英文作者：

单位：450000郑州，河南省人民医院（阜外华中心血管病医院）心内科

英文单位：

关键词：冠状动脉粥样硬化性心脏病；药物洗脱支架；介入治疗

英文关键词：

• 摘要：

• 【摘要】目的    探讨年龄对冠状动脉粥样硬化性心脏病（冠心病）患者药物洗脱支架（DES）介入治疗术后主要心脑血管不良事件(MACCE)的影响。方法    选取2014年1—12月在河南省人民医院成功接受DES介入治疗的冠心病患者920例，依据年龄分为老年组（≥60岁，457例）和非老年组（＜60岁，463例）。收集患者一般资料及冠状动脉病变情况，比较2组随访期间用药情况和MACCE发生情况，分析随访期间发生MACCE的影响因素。结果    老年组女性比例、年龄、合并高血压、既往心肌梗死比例高于非老年组，家族史和吸烟史比例、体重指数低于非老年组（均P＜0.05）。与非老年组比较，老年组多血管病变、右冠状动脉病变比例较高，冠状动脉参考直径较细，单位支架总长度较长，置入支架数目和治疗血管数目较多（均P＜0.05）。2组患者随访期间用药情况比较，差异无统计学意义（P＞0.05）。老年组随访期间全因性死亡、脑卒中及MACCE发生率明显高于非老年组，差异均有统计学意义（均P＜0.05）。Cox多元逐步回归分析显示，性别（风险比=1.027,95%置信区间：1.013～1.430，P=0.015）和年龄（风险比=1.056,95%置信区间：1.028～1.446，P=0.012）是接受DES介入治疗冠心病患者随访期间MACCE发生的重要危险因素。结论    年龄是冠心病患者接受DES治疗后MACCE发生的重要危险因素。

• 【Abstract】Objective    To investigate the influence of age on major adverse cardio-cerebrovascular events（MACCE） in patients with coronary atherosclerotic heart disease(CHD) who underwent successful percutaneous coronary intervention with drug-eluting stent（DES） implantation. Methods    From January 2014 to December 2014, 920 CHD patients who underwent successful DES intervention in Henan Provincial People′s Hospital were enrolled and they were divided into elderly group（age≥60 years, n=457）and non-elderly group（age＜60 years, n=463）. General clinical information, coronary artery lesion characteristics, medicine use and occurrence of MACCE during follow-up were recorded. Influence factors of MACCE were analyzed. Results    Female ratio, age, hypertension ratio and previous myocardial infarction ratio in the elderly group were significantly higher, ratios of family history and smoking history and body mass index were significantly lower than those in the non-elderly group(P＜0.05). Multivascular lesion and right coronary artery lesion in the elderly group were more, reference vessel diameter was smaller, the total length of stents was longer, the numbers of stents and target vessels were more than those in the non-elderly group(P＜0.05). There was no significant difference of medication between the two groups during follow-up(P＞0.05). In the elderly group, incidences of all-cause death, stroke and MACCE were significantly higher than those in the non-elderly group(P＜0.05). Cox multivariate regression analysis showed that gender(hazard ratio=1.027, 95% confidence interval: 1.013-1.430， P=0.015) and age(hazard ratio=1.056, 95% confidence interval: 1.028-1.446, P=0.012) were risk factors of MACCE. Conclusion    Age is an important predictive factor of MACCE after DES intervention in CHD patients.