老年冠心病合并肾功能不全患者进行冠脉介入治疗的临床效果研究-现代医学

老年冠心病合并肾功能不全患者进行冠脉介入治疗的临床效果研究

单位：1. 北京市垂杨柳医院老年病科, 北京 100022;
2. 天津医科大学总医院内分泌代谢科, 天津 300052

分类号：R541.4

出版年·卷·期（页码）：2018·46·第二期（209-213）

摘要：

目的：探究冠脉介入治疗老年冠心病合并肾功能不全患者的临床效果。方法：回顾性分析2011年1月~2016年2月我院收治的200例老年冠心病患者的临床资料，其中合并肾功能不全者有100例，作为观察组；另100例患者肾功能正常，作为对照组；两组患者均在常规药物治疗的基础上给予冠脉介入治疗。比较两组患者的冠脉病变情况、心功能、肾功能、CIN发生率及不良心脏事件发生情况。结果：观察组多支血管、B型、C型病变发生率均较对照组高，而A型病变发生率较对照组低，组间比较差异具有统计学意义（P<0.05）；观察组治疗后LVEF值低于对照组，而ED、ES值高于对照组，治疗后组间比较差异具有统计学意义（P<0.05）；两组患者治疗前后不同时间点的Scr、GFR值比较均具有统计学意义（P<0.05），而组内治疗前后的Scr、GFR值比较无统计学意义（P>0.05）；观察组患者治疗后CIN、NFHF、CD发生率均较对照组高，比较差异具有统计学意义（P<0.05）；而两组患者RAMI、UA、TVR发生率比较差异无统计学意义（P>0.05）。结论：冠脉介入术治疗老年冠心病合并肾功能不全是有效的、安全的，值得在临床上推广应用，但预后差于肾功能正常冠心病患者。

Objective: To explore the clinical effect of coronary intervention in elderly patients with coronary heart disease complicated with renal insufficiency. Methods: The clinical data of 200 elderly patients with coronary heart disease from January 2011 to February 2016 were retrospectively analyzed. Among them, 100 patients with renal insufficiency were treated as observation group. The other 100 patients had normal renal function as the control group; both groups were given coronary intervention ontop of the conventional drug therapy. The incidence of coronary artery disease, cardiac function, renal function, CIN and adverse cardiac events were compared between the two groups. Results: The incidence of multi-vessel, type B and C lesions in the observation group was higher than that in the control group, respectively, and the incidence of type A disease was lower than that of the control group, the difference between the two groups was statistically significant (P<0.05). The LVEF value of the observation group was lower than that of the control group, while the ED and ES values were higher than those in the control group, and the difference was statistically significant (P<0.05). Scr, GFR values of the two groups of patients before and after treatment at different time points were statistically significant (P<0.05),Scr and GFR values before and after treatment were not statistically significant (P>0.05). The incidence of CIN, NFHF and CD in the observation group was higher than that in the control group, the difference was statistically significant (P<0.05). There was no significant difference in the incidence of RAMI, UA and TVR between the two groups (P> 0.05). Conclusion: Coronary intervention is an effective and safe method for the treatment of coronary heart disease complicated with renal insufficiency among elderly patients. Which is recommanded in clinical practice, but the prognosis is worse than that of patients with normal renal function.

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