| Background Coronary atherosclerotic heart disease has become a serious threat to human health as a killer.With the CHD increasing,the rate of multivessel lesion is also increasing.Coronary multivessel lesion means that the stenosis of coronary exceed 50% in more than two coronaries by atherosclerotic lesion,myocardial injured by ischemia worse and remodeling significantly.The more coronaries involved in lesion,the worse the disease and prognosis are,Some studies found that the incidence of CHD in men was obviously higher than in women,with the increasing of the aging,the elderly male patients with vascular lesions gradually increase,the elderly male patients always have failure in liver,renal and heart function,their prognosis will worse,and the risk of death will increase,so it's important to find the risk factors for elderly male multivessel lesion patients,this will make a guiding role in clinical work now.There are many factors leading elderly male multivessel lesion patients accept no chance for completely reascularization,so it's important to study the difference of prognosis between the group of incompletely reascularization and the group of completely reascularization.Objective To investigate the risk factors of elderly male patients with coronary multivessel lesion,and the prognosis of incomplete revascularization in elderly male patients with multivessel disease in one year,it will provide the basis for us to find out a way to cure or control the development of coronary multivessel lesion in the clinical.Methods Choose 203 male patients who are diagnosed as CHD by coronary angiography at our hospital between the 2013 to the 2014.They are divided into three groups according to the number of the lesion of their coronaries and their ages,the group of elderly male multivessel lesion patients(the coronaries which in lesion are more than two and older than60 years)including 74 cases;the group of elderly male single-vessel lesion patients(the coronary in lesion are only one and older than 60 years)including 66 cases;the group of non-aged male multivessel lesion patients(the coronaries which in lesion are more than two and less than 60 years)including 63 cases.2.collect the clinical data from two groups including age,hypertension,dyslipidemia,diabetes and the history of smoking;,also including the blood biochemical test result:total cholesterol,low-density-lipoprotein,high-density-lipoprotein,triglycerides,fasting blood--glucose,Uric acid,D-dimer and fibrinogen;3.To analyze the difference of prognosis between the group of incompletely reascularization and the group of completely reascularization in two years,including MACE and the recurrence of angina pectoris.Result Risk factor : Compare with the group of non-elderly male patients with multivessel disease,the rate of hypertension,diabetes and carotid artery atherosclerosis is higher(p?0.05)in the group of elderly male patients with multivessel disease;the FBG,LDL,D-dimer,fibrinogen and uric acid are higher in elderly male patients with multivessel lesion group than in the contrast group;the average of triglycerides are higher in the contrast group than in elderly male patients with multivessel lesion group;2.In elderly multivessel lesion group,the proportion of LM is higher than in the non-elderly group,but there are no sigsignificant difference between two groups about the proportion of LAD,LCX,RCA,the rate of double-vessel disease is higher in non-elderly male patients with multivessel lesion group and the rate of triple-vessel disease.is higher in elderly male patients with multivessel lesion group;3.Compare with the group of elderly male patients with single-vessel disease,the proportion of,hypertension,diabetes,dyslipidemia,carotid artery atherosclerosis is higher in multivessel lesion group(p?0.05);the analysis of the blood biochemical show that the average of TC,LDL,FBG,D-dimmer,fibrinogen and uric acid are higher in elderly male patients with multivessel lesion group than in the contrast group.From the regression analysis of Logistic,we know the risk factors of elderly male patients with multivessel lesion are hypertension,diabetes,LDL,D-dimmer,fibrinogen,uric acid and carotid artery atherosclerosis.4.This search compares completely reascularization group with incompletely reascularization group on elderly male patients with multivessel disease,from this search,we know that there's no obviously different between completely reascularization group with incompletely reascularization group on elderly male patients with multivessel disease on the rate of MACE and recurrence of angina pectoris(P?0.05).Conclusion It's useful to control the occurrence of elderly male patients with multivessel lesion from controlling the average of hypertension,diabetes,dyslipidemia,D-dimmer,fibrinogen,uric acid and carotid artery atherosclerosis.For a part of elderly male patients with multivessel lesion who couldn't accept a complete revascularization,it's useful to conduct an incomplete revascularization for improving the prognosis. |
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