本文選題：老年 + 非ST段抬高急性冠狀動脈綜合征��； 參考：《臨床心血管病雜志》2017年04期

【摘要】：目的:觀察老年中危非ST段抬高型急性冠狀動脈綜合征(NSTE-ACS)患者不同介入治療時機(jī)的臨床預(yù)后。方法:本研究為回顧性研究,按照2015年歐洲NSTE-ACS管理指南評判中危NSTE-ACS風(fēng)險標(biāo)準(zhǔn),連續(xù)納入本院2010-01-2013-06成功行經(jīng)皮冠狀動脈介入(PCI)治療的老年中危NSTE-ACS患者599例,根據(jù)入院后不同介入治療時間分為入院后24h內(nèi)介入組(195例)、24~72h內(nèi)介入組(234例)和72h后介入組(170例)。主要臨床終點為PCI術(shù)后3年隨訪期間包括心性死亡和心肌梗死、靶血管血運重建(TVR)在內(nèi)的主要心血管不良事件(MACE)的發(fā)生情況。結(jié)果:入院后24h內(nèi)介入組、24~72h介入組、72h后介入組3年MACE的發(fā)生率分別是11.4%、9.5%和23.7%(P=0.001),進(jìn)一步利用多因素Cox回歸分析顯示24h內(nèi)介入組患者M(jìn)ACE的發(fā)生率低于72h后介入組(OR:0.645,95%CI:0.437~0.963,P=0.021),24~72h介入組患者M(jìn)ACE的發(fā)生率低于72h后介入組(OR:0.372,95%CI:0.217~0.637,P=0.001),而24~72h介入組MACE的發(fā)生率與24h內(nèi)介入組未見明顯差異(OR:0.712,95%CI:0.386~1.313,P=0.276)。結(jié)論:對于老年中危NSTE-ACS患者,入院后72h內(nèi)較72h后干預(yù)可以減少患者M(jìn)ACE的發(fā)生率。
[Abstract]:Objective: To observe the clinical prognosis of different intervention treatments in elderly patients with non ST segment elevation acute coronary syndrome (NSTE-ACS). Methods: This study was a retrospective study. According to the European NSTE-ACS management guidelines in 2015 to evaluate the risk of intermediate risk NSTE-ACS, percutaneous coronary intervention was performed successfully in 2010-01-2013-06 in our hospital. PCI) 599 elderly patients with middle risk NSTE-ACS were divided into 24h internal intervention group (195 cases) after admission, 24~72h internal intervention group (234 cases) and post 72h intervention group (170 cases). The main clinical endpoint was cardiac death and myocardial infarction, and target vascular revascularization (TVR) during the 3 year follow-up of PCI operation. The occurrence of cardiovascular adverse events (MACE). Results: the incidence of MACE in 3 years after admission to 24h was 11.4%, 9.5% and 23.7% (P=0.001), respectively. The incidence of MACE in the patients with 24h intervention group was lower than that of 72h after the intervention group (OR:0.645,95%CI:0.437~0.963, P=0.0). 21) the incidence of MACE in the 24~72h intervention group was lower than that of the 72h after the intervention group (OR:0.372,95%CI:0.217~0.637, P=0.001), but the incidence of MACE in the 24~72h intervention group was not significantly different from that in the 24h intervention group (OR:0.712,95%CI:0.386~1.313, P=0.276). Conclusion: for the elderly patients with middle risk, the intervention in 72h after admission can reduce the incidence of the patients. The rate of occurrence.
【作者單位】： 安徽省立醫(yī)院心血管內(nèi)科;
【基金】：安徽省公益性技術(shù)應(yīng)用研究聯(lián)動計劃(No:15011d04032) 安徽省科技攻關(guān)計劃(No:1604a0802074)
【分類號】：R541.4

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