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【目的】分析经不同途径经皮冠状动脉介入治疗（PCI）高龄冠心病患者的随访结果及影响因素。【方法】选择2009年3月至2014年8月本院收治的283例高龄冠心病患者，根据不同介入途径 PCI 将患者分为桡动脉组（ n ＝150）和股动脉组（ n ＝133），观察两组介入情况及手术成功率。术后随访1～20个月，比较两组并发症及主要不良心血管事件发生情况。采用 Cox 回归分析影响 PCI 术后患者预后的相关因素。【结果】两组置入支架直径、数量及长度、手术成功率比较差异无统计学意义（ P ＞0．05）；桡动脉组介入途径更改发生率明显高于股动脉组（ P ＜0．05）。桡动脉组并发症发生率明显少于股动脉组（ P ＜0．05）。同时桡动脉组围术期小出血发生率明显少于股动脉组（ P ＜0．05），两组围术期大出血发生率，术后1年、1．5年主要不良心血管事件发生率比较差异无统计学意义（ P ＞0．05）。预后多因素 Cox 回归分析，年龄、支架数目及冠脉病变血管支数是 PCI 术后主要心脏事件发生的独立危险因素。 【结论】经桡动脉或经股动脉介入治疗高龄冠心病近远期疗效相似，其中经桡动脉介入治疗并发症相对明显少，但其介入途径变更率大。患者年龄、冠脉病变血管支数等均可能引发心脏事件，PCI 术后需积极采取有效措施预防。“,”Objective] To explore the follow‐up results and influencing factors of percutaneous coronary intervention (PCI) for elderly patients with coronary heart disease by different approaches .[Methods] From March 2009 to August 2013 ,a total of 283 elderly hospitalized patients with coronary heart disease were se‐lected and were divided into radial artery ( n = 150) and femoral artery ( n = 133) groups according to different intervention approaches .And the outcomes of intervention and successful operative rate of two groups were observed .During a follow‐up period of 1 ~ 20 months ,the occurrence of complications and major adverse car‐diovascular events were compared between two groups .And the relevant prognostic factors after PCI were an‐alyzed by Cox regression analysis .[Results] The differences in diameter ,number and length of implanted stents and successful operative rate were not statistically significant ( P > 0 .05) .The occurrence rate of inter‐vention approach changes was significantly higher in radial artery group than that in femoral artery group ( P< 0 .05) while the incidence of complications was significantly less than that in femoral artery group ( P <0 .05) .And the incidence of minor hemorrhage during perioperative period in radial artery group was signifi‐cantly less than that in femoral artery group ( P 0 .05) .And multivariate Cox regres‐sion analysis revealed that age ,number of stents and number of coronary artery lesion were the independent risk factors for major cardiac events after PCI .[Conclusion] The short and long‐term efficacies are similar for trans‐radial or trans‐femoral artery intervention in elderly patients with coronary heart disease .The complica‐tions of trans‐radial artery intervention are relatively fewer ,but the change rate of intervention approach is great .Age and number of coronary artery lesion may cause cardiac events .After PCI ,effective preventive measures should be actively taken .