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老年冠状动脉支架置入术的临床体会

Coronary stent implantation in the elderly patients

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【作者】 江时森陈锐华宫剑滨王立军彭永平张启高徐军严宝力王景何松清蔡晓敏邹莺刘保军诸葛海鸿蒋琳辉

【Author】 JIANG Shi sen, CHEN Rui hua, GONG Jian bin, WANG Li jun, PENG Yong ping, ZHANG Qi gao, XU Jun, YAN Bao li, WNAG Jing, HE Song qing, CAI Xiao min, ZOU Ying, LIU Bao jun, ZHU GE Hai hong, JIANG Lin hui (Department of Cardiology,Nanjing General Hospital of Nanjing Command,Nanjing 210002,Jiangsu,China)

【机构】 南京军区南京总医院心内科南京军区南京总医院心内科 江苏南京210002江苏南京210002江苏南京210002

【摘要】 目的 :初步评估老年冠心病患者的冠状动脉造影及支架置入术的临床特点。 方法 :将我院 182例年龄≥6 0岁的老年患者的冠状动脉造影狭窄分布和置入支架的分布情况进行统计 ,并与文献资料进行对照分析。 结果 :182例患者中 10 7例有单支、双支、3支或合并左主干病变 ,造影的阳性率为 5 8.8%。其中单支病变 4 1例 ,占38.32 % ,双支病变 32例 ,占 2 9.91% ,3支病变 2 1例 ,占 19.6 3% ,左主干 (LM )病变 13例 ,占 12 .14 %。造影结果显示 ,血管狭窄共计 199支 35 1处 ,其中LM 13支 13处 ,前降支 (LAD) 83支 14 4处 ,旋支 (LCX) 4 4支 87处 ,右冠状动脉 (RCA) 5 9支 10 7处。 199支狭窄血管共置入支架 12 2枚 ,扩张后置入支架的相关动脉为LAD 5 6例 6 0枚 ,LCX2 1例 2 4枚 ,RCA 30例 38枚。同一血管置入 2枚支架的有 10例患者。 12 2枚支架中 ,Coroflex支架 93枚 ,占 76 .2 3% ,Helistent支架 11枚 ,占 9.0 2 % ,AVE支架 17枚 ,占 13.92 % ,Bestent支架 1枚 ,占 0 .82 %。所有支架的直径范围为 2 .0~ 4 .0mm ,其中直径 2 .0mm 2枚 ,2 .5mm 2 3枚 ,3.0mm 4 9枚 ,3.5mm 2 9枚 ,4 .0mm 13枚 ;长度范围为 8~ 30mm ,其中≤ 10mm 2 1枚 ,10~ 15mm 4 3枚 ,16~ 2 0mm 37枚 ,2 1~ 2 5mm 13枚 ,>2 5mm 2枚。 结

【Abstract】 Objectives:To evaluate preliminary the clinical characteristics of coronary arteriography(CAG) and stent implantation in the elderly patients with coronary heart disease(CHD). Methods:The data of 182 elderly(more than 60 years) patietns’distribution of coronary artery stenosis and stents was statisticed and then analyzed and controlled with the literature. Results:In 182 patients,there were 107 had single branch,two branch,three branch coronary artery disease or accompanied with left main coronary artery(LM) lesions.The rate was 58.8%(107/182).Of these patients,41 had single branch lesion,account for 38.32%,32 had two branch lesion,29.91%,21 had three branch lesion,19.63% and 13 had LM lesion,12.14%.CAG showed that there were 199 stenosis coronary arteries with 351 target lesions in these patients.Of these lesions,13 were in 13 LM,144 in 83 left anterior descending branch(LAD),87 in 44 left circumflex branch(LCX) and 109 in 59 right coronary artery(RCA).For all the cases,there were 122 stents implanted in 199 stenosis vasculars.Of these,60 stents were implanted in target lesions in LAD of 56 cases,24 in LCX of 21 and 38 in RCA of 30.There were 10 patients who had 2 stents in the same vascular in all.To the stent’s style,there were 93 Coroflex stents,account for 76.23 %,17 AVE stents,13.92%,11 Helistents,9.02% and 1 Bestent, 0.82 %.All of their diameters were in the range of 2.0 ~4.0 mm of which 2 stents were in 2.0 mm,23 in 2.5 mm,49 in 3.0 mm,29 in 3.5 mm and 13 in 4.0 mm.And all of their length were in the range of 8~30 mm of which 21 stents were less than 10 mm,43 in 10~15 mm,37 in 21~25 mm and 2 more than 25 mm. Conclusions:It was similar to the literature that multivessel coronary strictures,especially in the LAD,were primary in the elderly patients while the LM lesion was common in the senility.In multivessel coronary artery diseases,the effective revascularization was achieved only by dilatating the most serious lesion when one vessel was seriously constrictive while the others had light or middle degree(<60%~70%) constriction or lesions of them were at the end.

【关键词】 冠状动脉造影支架置入老年
【Key words】 Coronary arteriographyStent implantationElderly
  • 【文献出处】 医学研究生学报 ,Journal of Medical Postgraduates , 编辑部邮箱 ,2003年03期
  • 【分类号】R541.4
  • 【被引频次】22
  • 【下载频次】19
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