西罗莫司洗脱支架联合低分子肝素在老年冠心病介入治疗中的疗效及近远期预后
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山东省青岛市医药卫生科研指导项目(2023-WJZD236);


Effect and both short-term and long-term prognosis of sirolimus-eluting stents in conjunction with low molecular weight heparin in elderly patients undergoing percutaneous coronary intervention for coronary heart disease
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    摘要:

    目的:探究西罗莫司洗脱支架联合低分子肝素在老年冠心病(CHD)介入治疗中的临床效果,并进行12个月的随访,观察近远期预后。方法:选取行冠状动脉介入术(PCI)治疗的114例老年CHD患者为研究对象,按照治疗方案不同分为对照组(n=57)和研究组(n=57)。对照组患者PCI中置入西罗莫司洗脱支架;研究组患者在对照组的基础上联合应用低分子肝素。记录两组患者研究期间的心功能指标水平、冠状动脉灌注恢复情况及心肌标志物等指标水平,并对受试者进行12个月的随访,观察近远期预后情况。结果:治疗后,两组患者左心室射血分数(LVEF)、最大摄氧量(VO2max)、6 min步行试验(6MWT)水平均较治疗前增高(P<0.05),且研究组较对照组改善效果更佳(P<0.05);治疗后24 h,两组患者均未产生复流情况,研究组患者TIMI血流3级占比高于对照组(P<0.05),慢血流患者例数及CTFC低于对照组(P<0.05);治疗后,两组患者血清肌红蛋白(MYO)、肌酸激酶同工酶(CK-MB)、肌钙蛋白(cTn)水平均较治疗前降低(P<0.05),且研究组低于对照组(P<0.05);两组患者近期预后不良占比无统计学差异(P>0.05);研究组患者远期预后不良率为10.53%,低于对照组的28.07%(P<0.05)。结论:西罗莫司洗脱支架联合低分子肝素在老年CHD介入治疗中可获得更高的效果,提高远期预后,应用价值较高。

    Abstract:

    Objective:To evaluate the clinical efficacy of sirolimus-eluting stents in conjunction with low molecular weight hepa-rin for the interventional treatment of coronary heart disease(CHD)in elderly patients,and to assess both short-term and long-term out-comes following a 12-month follow-up period.Methods:A total of 114 elderly patients with coronary heart disease(CHD)who under-went percutaneous coronary intervention(PCI)were divided into a control group(n=57)and an experimental group(n=57)based on differing treatment protocols.Patients in the control group received sirolimus-eluting stents during PCI,while those in the experimen-tal group received low molecular weight heparin in addition to the standard treatment regimen.Throughout the study period,cardiac function indices,coronary perfusion recovery,and myocardial marker levels were systematically recorded for both groups.Additionally,subjects were followed up for 12 months to evaluate both short-term and long-term prognostic outcomes.Results:After treatment,the levels of left ventricular ejection fraction(LVEF),maximum oxygen uptake(VO2max),and 6-minute walk test(6MWT)in both groups exhibited improvements compared to pre-treatment values.Furthermore,the study group demonstrated greater improvement than the con-trol group(P<0.05).After 24 hours of treatment,there was no occurrence of the no-reflow phenomenon in either group.The study group exhibited a higher proportion of TIMI blood flow grade 3 compared to the control group,while experiencing lower incidences of slow blood flow and CTFC(P<0.05).After treatment,the levels of serum Myoglobin(MYO),Creatine Kinase-MB(CK-MB),and Cardiac Troponin(cTn)in both groups exhibited a decrease compared to pre-treatment levels,with the study group demonstrating a greater reduction than the control group(P<0.05).There was no significant disparity observed in the proportion of patients with poor short-term prognosis between the two groups(P>0.05).The study group exhibited a lower rate of poor long-term prognosis at 10.53%,compared to 28.07% in the control group,which was found to be statistically significant(P<0.05).Conclusion:The com-bination of sirolimus-eluting stents and low molecular weight heparin demonstrates superior efficacy in the interventional treatment of CHD in elderly patients,enhances long-term prognosis,and exhibits clinical application value.

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何顺舟;曲迪;张宝库;盛斌;姜靖;.西罗莫司洗脱支架联合低分子肝素在老年冠心病介入治疗中的疗效及近远期预后[J].川北医学院学报,2025,40(7):883-887.

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  • 在线发布日期: 2025-08-10
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