PCI与优化药物治疗对老年冠心病患者长期生活质量及预后的影响

doi:10.3969/j.issn.1671-7171.2025.03.008

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摘要【目的】探讨经皮冠状动脉介入治疗(PCI)与优化药物治疗(ODT)对老年冠心病患者长期生活质量及预后的影响。【方法】回顾性分析2018年6月至2023年6月本院收治的178例老年冠心病患者的临床资料,根据治疗方式的不同将患者分为PCI组(n=88)和ODT组(n=90)。比较两组患者的心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、每搏输出量(SV)]、运动能力指标[6 min步行试验(6MWT)]、肺功能指标[第1秒用力呼气容积(FEV₁)、最大肺活量(VC_max)、用力肺活量(FVC)]、血清生化标志物[肌钙蛋白I(cTnI)、N-末端脑钠肽前体 (NT-proBNP)、肌酸激酶同工酶-MB(CK-MB)]以及生活质量评分[冠心病生活质量量表(MacNew HRQL)评分]。采用多因素Cox回归模型分析两组患者主要不良心血管事件(MACE)发生率。【结果】治疗后,两组LVEF、SV均高于治疗前,且PCI组LVEF、SV均高于ODT组;两组LVEDD低于治疗前,且PCI组低于ODT组,差异有统计学意义(P<0.05)。治疗后,两组6MWT、FEV₁、VC_max、FVC均高于治疗前,且PCI组高于ODT组,差异有统计学意义(P<0.05)。治疗后,两组血清cTnI、NT-proBNP、CK-MB水平均低于治疗前,且PCI组低于ODT组,差异有统计学意义(P<0.05)。治疗后,两组MacNew HRQL各维度评分高于治疗前,且PCI组高于ODT组,差异有统计学意义(P<0.05)。PCI组MACE总发生率明显低于ODT组(P<0.05)。【结论】PCI改善冠心病患者心功能和运动能力方面效果显著,同时在提高患者生活质量及降低长期心血管风险方面具有显著优势。

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	周晓萍

关键词 ：冠心病, 经皮冠状动脉介入治疗, 药用制剂, 生活质量, 预后

Abstract：【Objective】To investigate the effects of percutaneous coronary intervention (PCI) and optimal drug therapy (ODT) on long-term quality of life and prognosis in elderly patients with coronary heart disease. 【Methods】The clinical data of 178 elderly patients with coronary heart disease admitted to our hospital from June 2018 to June 2023 were retrospectively analyzed, and the patients were divided into percutaneous coronary intervention group (PCI group, n=88) and optimized drug therapy group (ODT group, n=90) according to different treatment methods. The two groups were compared in terms of the cardiac function indexes of [left ventricular ejection fraction (LVEF), Left ventricular end-diastolic diameter (LVEDD), stroke output (SV)], index of exercise ability [6 min walking test (6MWT)], pulmonary function index [forced expiratory volume (FEV₁), maximum vital capacity (VC_max), forced vital capacity (FVC)], serum biochemical markers [Troponin I(cTnI), N-terminal brain natriuretic peptide precursor (NT-proBNP), creatine kinase isozyme-MB (CK-MB)] and quality of life scores [Coronary heart disease Quality of Life Scale (MacNew HRQL) score]. Multivariate Cox regression model was used to analyze the incidence of major adverse cardiovascular events (MACE) in the two groups. 【Results】After treatment, LVEF and SV in both groups were higher than before treatment, LVEF and SV in PCI group were higher than ODT group, LVEDD in both groups was lower than before treatment, the PCI group was lower than the ODT group, the difference was statistically significant (P<0.05). After treatment, 6MWT, FEV₁, VC_max and FVC in both groups were higher than before treatment, and the PCI group was higher than the ODT group, with statistical significance (P<0.05). After treatment, serum levels of cTnI, NT-proBNP and CK-MB were low in both groups. Before treatment, the PCI group was lower than the ODT group, and the difference was statistically significant (P<0.05). After treatment, MacNew HRQL scores in both groups were higher than before treatment, and the PCI group was higher than the ODT group, with statistical significance (P<0.05). The cumulative incidence of MACE in PCI group was significantly lower than that in ODT group (P<0.05). 【Conclusion】PCI can improve cardiac function and exercise ability in patients with coronary heart disease, and has significant advantages in improving quality of life and reducing long-term cardiovascular risk.

Key words： Coronary Disease Percutaneous Coronary Intervention Pharmaceutical Preparations Quality of Life Prognosis

收稿日期: 2024-03-04

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R541.4

引用本文:

周晓萍. PCI与优化药物治疗对老年冠心病患者长期生活质量及预后的影响[J]. 医学临床研究, 2025, 42(3): 394-397.
ZHOU Xiaoping. Effect of PCI and Optimized Drug Therapy on Long-Term Quality of Life and Prognosis in Elderly Patients with Coronary Heart Disease. JOURNAL OF CLINICAL RESEARCH, 2025, 42(3): 394-397.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.03.008 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I3/394

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