【摘要】 目的评估年轻冠心病患者(<45岁)冠状动脉(冠脉)内支架术的长期疗效。方法选65例年龄<45岁的患者接受冠脉内支架术治疗(年轻组),随机同期选取65例年龄>45岁行冠脉内支架术患者作为对照组。比较两组一般情况、冠脉病变、介入治疗及3年临床随访情况。结果年轻组患者心梗68%比对照组35%多见,P<0.05;单支冠脉病变患者明显增多(83%比57%,P=0.001);介入治疗后达到完全血运重建者增多(95%比78%,P=0.004)。平均随访87±13月,年轻组患者再发胸痛及再次住院发生率明显高于对照组(分别为35%和17%,P=0.02,28%和14%,P=0.05),新生病变发生率明显高于对照组(分别为23%和9%,P=0.03;35%和17%,P=0.02)。结论年轻患者冠脉裸支架术完全血运重建率高,术后心脏事件的发生主要由新生冠脉病变引起。冠脉支架植入术可作为年轻冠心病患者的可选治疗方式之一。更多还原

【Abstract】 Objective To evaluate the long-term effect of coronary stent in young patients(<45 years) with coronary artery disease.Methods From July 1996 to March 2002,65 patients younger than 45 years undergone coronary stent implantation were included as younger group.Another 65 contemporary older patients(>45 years) undergone coronary stent were served as the control group.The general characteristics,coronary angiography,interventional and follow-up information were compared between these two groups.Results Compared with the control group,the young group patients were presented with much more myocardial infarction(68% Vs 35%,P<0.05) and single-vessel disease(83% Vs 57%,P=0.001).There were more patients with complete revascularization in the young group(95% Vs 78%,P=0.004).During a mean 87±13 months’ follow-up,recurrent angina and readmission rate were higher in the young group,as well as the incidence of MACE.Repeat CAG revealed much more de novo lesions in the young group(44%Vs 11%,P=0.02) and higher rate of re-stenting. Conclusions Due to the accelerated process of coronary atherosclerosis in young patients,coronary bare metal stent implantation should be regarded as one of the available choices of treatment.更多还原