Ploenes C, Broers G, Martin M
Geriatrische Klinik, Städtischen Kliniken Duisburg.
Vasa Suppl. 1993;39:17-22.
In a retrospective study, the data of 218 patients (age 65-91) with obstructions of leg-arteries were evaluated, who underwent short-term ultrahigh fibrinolytic treatment. Some of the patients were also treated with percutaneous transluminal angioplasty after fibrinolysis. The overall patency-rate was 69 percent in the younger age group (65-74 years) and 46 percent in the group aged > or = 75. It could be shown, however, that the patency-rate was affected positively by concomitant factors (especially at least two patent calf arteries). These factors were less frequently found in the older age group, resulting in a lower patency-rate. Most likely the underlying reason is not age per se, because it could be shown, that the reason, which led to fibrinolytic treatment changed with age: In the younger age-group, Fontaine-stage II led to treatment in the vast majority of cases (71%). There was a shift to stage III (26%) and IV (27%) in the group > or = 75 years. This progression of artery disease usually leads to a reduced success rate of fibrinolytic treatment, because adverse concomitant factors prevail.
在一项回顾性研究中，对218例年龄在65至91岁之间、患有下肢动脉阻塞的患者的数据进行了评估，这些患者接受了短期超高效溶栓治疗。部分患者在溶栓后还接受了经皮腔内血管成形术。在较年轻的年龄组（65至74岁）中，总体通畅率为69%，而在年龄大于或等于75岁的组中为46%。然而，可以看出，通畅率受到伴随因素（尤其是至少两条小腿动脉通畅）的积极影响。这些因素在老年组中较少见，导致通畅率较低。最可能的根本原因并非年龄本身，因为可以证明，导致溶栓治疗的原因随年龄而变化：在较年轻的年龄组中，绝大多数病例（71%）是因Fontaine II期而接受治疗。在年龄大于或等于75岁的组中，这一比例向III期（26%）和IV期（27%）转变。这种动脉疾病的进展通常会导致溶栓治疗成功率降低，因为不良伴随因素占主导。
