[1]秦 涛,许 飚,丛壮壮,等.老年冠心病患者冠脉旁路移植及冠脉支架术后生活质量比较[J].医学研究与战创伤救治(原医学研究生学报),2015,17(03):259-262.[doi:10.3969/j.issn.1672-271X.2015.03.011]
　QIN Tao,XU Biao,CONG Zhuang-zhuang,et al.The evaluation of the midterm functional quality of life in senile patients after coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI)[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2015,17(03):259-262.[doi:10.3969/j.issn.1672-271X.2015.03.011]
点击复制

老年冠心病患者冠脉旁路移植及冠脉支架术后生活质量比较()

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第17卷
期数:
2015年03期
页码:
259-262
栏目:
出版日期:
2015-05-20

文章信息/Info

Title:
The evaluation of the midterm functional quality of life in senile patients after coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI)
作者:
秦 涛; 许 飚; 丛壮壮; 张 雷; 李德闽
210002 江苏南京，南京军区南京总医院（南京大学医学院临床学院）心胸外科
Author(s):
QIN Tao;  XU Biao;  CONG Zhuang-zhuang;  ZHANG Lei;  LI De-min.
Department of Cardiothoracic Surgery， Nanjing General Hospital of Nanjing Military Command/Medicine School of Nanjing University， Nanjing， Jiangsu 210002， China
关键词:
老年; 冠心病; 冠状动脉旁路移植术; 冠脉支架植入术; 心功能; 生活质量
Keywords:
senile patients;  coronary heart disease;  coronary artery bypass graft;  percutaneous coronary intervention;  ventricular function;  long-term quality of life
分类号:
R541.4
DOI:
10.3969/j.issn.1672-271X.2015.03.011
文献标志码:
A
摘要:
目的 冠状动脉旁路移植术（CABG）和冠脉支架植入术（PCI）两种术式对改善高龄患者生活质量、减少心血管意外事件发生及延长寿命均有显著的效果。本研究对PCI和CABG术后老年冠心病患者进行术后生活质量长期随访，旨在探讨两种治疗方法对冠脉血运重建的远期效果，并以此为基础对比患者心功能的改善情况，进而评估CABG和PCI在术后远期生活质量方面给老年患者带来的效果。方法 选自2003年2月1日-2012年8月31日入某院心胸外科接受CABG的70岁以上老年冠心病患者117例（CABG组）及同期医院心内科行PCI的老年患者115例（PCI组）。经电话随访收集患者术后相关指标，收集两组患者治疗后主要心血管不良事件的再发情况及血运重建术后患者的生活质量，通过KPS及Barthel评分对比两组患者在生活自理、自主锻炼等相关指标，比较两组患者心功能的恢复情况及远期生活质量。结果 CABG和PCI患者的Barthel评分结果分别为（75.6±12.2）及（65.5±10.5）。术后2年再入院情况对比CABG组为27.4%，PCI组为61.7%（P<0.05）。CABG后患者中有57.7%在术后2年以上时间内完全自主生活，对比PCI组为23.9%（P<0.05），CABG组患者79.4%能进行日常锻炼，PCI组仅有40.2%能进行日常锻炼（P<0.05）。结论 CABG与PCI治疗相比较，对于老年冠心病患者改善心功能具有优势，再入院明显减少，日常锻炼更加普遍，远期生活质量得到更好的改善。
Abstract:
Objective Coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) improve the quality of life of patients and reduce the cardiovascular accidents. The aim of this study is to evaluate the improvement of ventricular dysfunction and then to estimate the midterm functional quality of life in senile patients after CABG and PCI. Methods From February 1， 2003 to August 31， 2012， 117 consecutive patients above age 70 underwent CABG and 115 consecutive patients underwent PCI. Using the Karnofsky Performance Score and Barthel Index， patients were evaluated for functional autonomy， living disposition， and leisure activity by a single telephone interview. Results The average Barthel score of CABG group was （75.6±12.2） and PCI group was （65.5±10.5）. The readmission rate at two years in CABG Group was 27.4%， while the PCI group was 61.7% (P<0.05). Among survivors in CABG group， 57.7% were autonomous， and 79.4% have some exercise. For the PCI group， 23.9% were autonomous and only 40.2% do have exercise (P<0.05). Conclusion For the senile patients (≥70 years) coronary artery bypass graft provide them with obvious promotion of ventricular dysfunction and an excellent quality of life in futurity.

参考文献/References:

[1]McKellar SH，Brown ML，Frye RL，et al.Comparison of coronary revascularization procedures in octogenarians：a systematic review and meta-analysis[J].Nat Clin Pract Cardiovasc Med，2008，5(11)：738-746.
[2]Vasques F，Rainio A，Heikkinen J，et al.Off-pump versus on-pump coronary artery bypass surgery in patients aged 80 years and older：institutional results and meta-analysis[J].Heart Vessels，2013，28(1)：46-56.
[3]Baskett R，Buth K，Ghali W，et al.Outcomes in octogenarians undergoing coronary artery bypass grafting[J].CMAJ，2005，172(9)：1183-1186.
[4]Filsoufi F，Rahmanian PB，Castillo JG，et al.Results and predictors of early and late outcomes of coronary artery bypass graft surgery in octogenarians[J].J Cardiothorac Vasc Anesth，2007，21(6)：784-792.
[5]Sirola J，Pitkala KH，Tilvis RS，et al.Definition of frailty in older men according to questionnaire data (RAND-36/SF-36)：The Helsinki Businessmen Study[J].J Nutr Health Aging，2011，15(9)：783-787.
[6]Afilalo J，Mottillo S，Eisenberg MJ，et al.Addition of frailty and disability to cardiac surgery risk scores identifies elderly patients at high risk of mortality or major morbidity[J].Circ Cardiovasc Qual Outcomes，2012，5(2)：222-228.
[7]王 磊，宫剑滨，彭永平，等.冠心病住院患者冠状动脉介入诊疗依从性的初步研究[J].东南国防医药，2012，14(4)：305-307.
[8]Munk PS，Staal EM，Butt N，et al.High-intensity interval training may reduce in-stent restenosis following percutaneous coronary intervention with stent implantation：A randomized controlled trial evaluating the relationship to endothelial function and inflammation[J].Am Heart J，2009，158（5）：734-741.
[9]Ben Ahmed H，Hamdi I，Elkateb T，et al.Benefits of coronary revascularization in septuagenarian patients with acute coronary syndrome[J].Tunis Med，2013，91(8-9)：539-543.
[10]Akcakoyun M，Kargin R，Tanalp AC，et al.Predictive value of noninvasively determined endothelial dysfunction for long-term cardiovascular events and restenosis in patients undergoing coronary stent implantation：a prospective study[J].Coron Artery Dis，2008，19(5)：337-343.
[11]Klapper J，Hirji S，Hartwig MG，et al.Outcomes after pneumonectomy for benign disease：the impact of urgent resection[J].J Am Coll Surg，2014，219(3)：518-524.
[12]Stolker JM，Kennedy KF，Lindsey JB，et al.EVENT Investigators.predicting restenosis of drug-eluting stents placed in real-world clinical practice：derivation and validation of arisk model from the EVENT registry[J].Circ Cardiovasc Interv，2010，3(4)：327-334.
[13]Crooks V，Waller S，Smith T，et al.The use of the Karnofsky Performance Scale in determining outcomes and risk in geriatric outpatients[J].J Gerontol，1991，46(4)：M139-144.
[14]Khan JH，McElhinney DB，Hall TS，et al.Cardiac valve surgery in octogenarians：improving quality of life and functional status[J].Arch Surg，1998，133(8)：887-893.
[15]Davoodi S，Sheikhvatan M，Karimi A，et al.Outcomes and long-term quality of life of patients with severe left ventricular dysfunction who underwent coronary artery bypass surgery[J].Gen Thorac Cardiovasc Surg，2012，60(4)：202-212.
[16]熊 宁，王 强，曾素琴，等.冠心病患者颈动脉粥样硬化与冠状动脉粥样硬化的相关性[J].东南国防医药，2012，14(3)：247-248.
[17]Giallauria F，Cirillo P，D’agostino M，et al.Effects of exercise training on high-mobility group box-1 levels after acute myocardial infarction[J].J Card Fail，2011，17(2)：108-114.
[18]Rodriguez AE.Coronary artery bypass surgery or coronary stenting in diabetic patients：too soon to make a statement?[J] Cardiovasc Revasc Med，2014，15(8)：421-423.
[19]Wolkanin-Bartnik J，Pogorzelska H，Bartnik A.Patient education and quality of home-based rehabilitation in patients older than 60 years after acute myocardial infarction[J].J Cardiopulm Rehabil Prev，2011，31(4)：249-253.

相似文献/References:

[1]徐幼桥,李伟求,江时森,等.老年2型糖尿病患者急性心肌梗死早期血糖变异对冠状动脉病变的影响[J].医学研究与战创伤救治(原医学研究生学报),2013,15(02):122.
　.Outpatient Clinic,Joint Logistics Department of Nanjing Military Command,Nanjing,et al.XU You-qiao1,LI Wei-qiu1,JIANG Shi-sen2,GONG Jian-bin2,CHEN Yi-tian2,LIU Ting-song2[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2013,15(03):122.
[2]丁海敬.老年食管癌患者自杀未遂1例的护理[J].医学研究与战创伤救治(原医学研究生学报),2013,15(03):312.[doi:10.3969/j.issn.1672-271X.2013.03.033]
[3]李冬梅.老年危重患者PICC置管的护理对策及并发症处理[J].医学研究与战创伤救治(原医学研究生学报),2013,15(03):300.[doi:10.3969/j.issn.1672-271X.2013.03.037]
[4]任绍学,何幼英,罗助荣.瑞舒伐他汀钙治疗冠心病合并高脂血症疗效分析[J].医学研究与战创伤救治(原医学研究生学报),2013,15(04):403.[doi:10.3969/j.issn.1672-271X.2013.04.029 ]
[5]朱 英.老年原发性十二指肠肿瘤34例诊治分析[J].医学研究与战创伤救治(原医学研究生学报),2013,15(05):466.[doi:10.3969/j.issn.1672-271X.2013.05.032]
[6]储旭东,周 敏,蔡福金,等.老年肱骨近端骨折的手术治疗及疗效探讨[J].医学研究与战创伤救治(原医学研究生学报),2012,14(06):538.
[7]吴炜炜,张 莉,周曼颖.老年重度酒精中毒并发呼吸衰竭的急救护理1例[J].医学研究与战创伤救治(原医学研究生学报),2012,14(06):493.
[8]方 红,张兴虎.56例高龄社区获得性肺炎的临床分析[J].医学研究与战创伤救治(原医学研究生学报),2012,14(01):8.
[9]童成刚,崔云惠,于连荣,等.曲美他嗪治疗老年冠心病稳定性心绞痛的疗效观察[J].医学研究与战创伤救治(原医学研究生学报),2012,14(02):138.
　TONG Cheng-gang,CUI Yun-hui,YU Lian-rong,et al.The clinical observation of trimetazidine treatment of coronary heart disease with stable angina in aged patients[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2012,14(03):138.
[10]苑小历,游云鹏,潘士勇,等.MTHFR基因多态性及同型半胱氨酸与老年冠心病的相关性[J].医学研究与战创伤救治(原医学研究生学报),2012,14(04):320.
　YUAN Xiao-li,YOU Yun-peng,PAN Shi-yong,et al.The correlation between MTHFR gene polymorphisms and levels of plasma homocysteine (Hcy) in elderly patients with coronary heart disease[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2012,14(03):320.

备注/Memo

备注/Memo:
-
更新日期/Last Update: 2015-05-20