老年冠状动脉粥样硬化性心脏病患者心血管支架的置入效果:安全与有效性评估

目的:总结老年冠状动脉粥样硬化性心脏病患者予以心血管支架置入后的效果.方法:收集1990/2008发表的老年心血管冠状动脉粥样硬化性心脏病患者心血管支架置入治疗对照实验和临床应用的中文文献10篇,从实验分组、实验材料、观察方法、实验结果、实验结论加以整理,同时对临床应用中的对象基本资料加以分析,并结合其随访和功能评价等指标检测结果.结果:从10篇有关老年冠状动脉粥样硬化性心脏病心血管支架置入的文献中可以看出,老年冠状动脉粥样硬化性心脏病的支架置入是介入心脏病学中发展最快和最具挑战性的领域.目前,包括老年患者冠状动脉支架的疗效及应用价值已经得到循证医学的验证,进一步提高手术的安全性、用支架置入手段治疗解剖形态更复杂的老年冠状动脉粥样硬化性心脏病患者、提高慢性闭塞病变的支架置入成功率、桥血管病变的支架置入和征服再狭窄仍然是未来几年内的工作重点.探索和研制新的药物、新的器械和新的支架置入方法都是非常有意义的工作.结论:老年冠状动脉粥样硬化性心脏病患者正日益增多,血运重建治疗也还存在诸多有待回答的问题,必须在充分反映当代心血管支架置入和搭桥进展的基础上,针对不同的年龄层次、临床与病变特征设计更多的大规模随机试验,以便更好地指导临床实践.

Effect of coronary stent implantation on elderly patients with coronary heart disease: Evaluation of safety and efficacy

OBJECTIVE: To summarize the therapeutic effect of coronary stent implantation on elderly patients with coronary heart disease(CHD).METHODS: Ten literatures regarding controlled experiment of treating CHD with coronary stent implantation in elderly patients, writing in Chinese language, published from 1990 to 2008, were selected. The literatures were sorted from experimental grouping, materials, observation methods, results, and conclusions. Simultaneously, the baseline data of subjects in the experiment were analyzed, and the follow up and functional evaluation were included to check the results.RESULTS: The literatures showed that treating CHD with coronary stent implantation in elderly patients was a fast developing and challenging field in interventional cardiology, the therapeutic effect and value of which had been proved by evidence based medicine. However, how to elevate the safety of procedures, increase the successful rate, and prevent restenosis were needed to be exploring in future. The exploration of new drugs, new equipment and inserting technique of scaffold implantation were important to solve the existed problems.CONCLUSION: More elderly patients suffered CHD need treating, but plenty of problems still existed in revascularization,therefore, it is necessary to perform large-scale randomized controlled trials containing different ages and pathologic characters for guiding the clinical practice.