【摘要】 目的 探讨老年冠状动脉慢性完全闭塞(CTO)病变的患者行逆向介入治疗的可行性。方法 选择2004年1月至2015年5月沈阳军区总医院心内科收治的行逆向介入治疗的≥60岁老年CTO患者119例(老年组)及同期行逆向介入治疗的<60岁CTO患者136例(非老年组),对比分析两组患者逆向介入治疗手术成功率、治疗效果及并发症的发生率。结果 与非老年组比较,老年组更多合并高血压、糖尿病、脑血管疾病(均P<0.05);老年组欧洲心血管手术危险因素评分系统(EuroSCORE)评分明显高于非老年组(P<0.001)。老年组合并双支和三支血管病变患者多于非老年组(均P=0.000);而老年组发生单支血管病变患者数低于非老年组(P=0.000)。老年组SYNTAX评分高于非老年组,差异具有统计学意义(P<0.001)。非老年组CTO时间为3~12个月的病例明显多于老年组,而老年组CTO时间为6~9年和>9年的病例明显多于非老年组(均P=0.000)。结论 本研究的结果 表明逆向介入治疗对老年患者是安全有效的方法 。更多还原

【Abstract】 Objective To investigate the feasibility of retrograde percutaneous intervention in treatment of coronary chronic total occlusion(CTO) in the elderly.Methods All patients who undergoing retrograde percutaneous recanalization for coronary CTO in our hospital from January 2004 to May 2015 were enrolled in this study.They were divided into the elderly group(n = 119,5= 60 years old) and the non-elderly group(n = 136,< 60 years old).Successful rate of retrograde PCI,efficacy and incidence of complications were compared and analyzed between the 2 groups.Results The elderly group had more comorbidities,such as hypertension,diabetes,cerebrovascular diseases(all P < 0.05),and higher score of European system for cardiac operative risk evaluation(EuroSCORE,P< 0.001) than in the non-elderly group.There were more patients having double and triple vessel coronary artery diseases in the former than in the latter group(both P = 0.000).While,the incidence of single-vessel disease was lower in the elderly group than in the non-elderly group(P = 0.000).The SYNTAX scores were higher in the former than in the latter group,with significant differences(P < 0.001).The proportion of patients having CTO for 3 to 12 months was significantly larger in the non-elderly group than in the elderly one,while that of those having CTO for 6 to 9 years or longer than 9 years was larger in the elderly group(both P = 0.000).Conclusion Retrograde percutaneous recanalization is a safe and effective approach for coronary CTO in the elderly.更多还原