摘要
目的 探讨西罗莫司 (雷帕霉素 )药物洗脱支架 (CypherTM)在不稳定型心绞痛 (UAP)中应用的安全性和有效性。方法 选择我院 2 0 0 2年 1 1月至 2 0 0 4年 6月间收治的不稳定型心绞痛 1 1 3例 ,在经皮冠状动脉介入治疗 (PCI)过程中置入CypherTM;选择同时期置入普通支架的UAP患者 1 1 3例作为对照。随访 6个月 ,比较两组间心血管事件发生率和再狭窄发生率的差别。结果 2 2 6例患者PCI治疗均获得成功。和普通支架组相比 ,药物支架组的糖尿病患者比例高 (2 4 8%vs 1 1 3%,P <0 0 1 )。在介入治疗中 ,药物支架组的复杂病变比例明显比普通支架组多 (B2 /C型病变所占比例分别为 5 5 4%vs37 4%,P <0 0 1 )。两组选用的支架内径相比较 ,药物支架组明显偏小 [(2 7± 0 4)mmvs(3 2± 0 3)mm ,P <0 0 1 ];支架长度两组相比 ,药物支架组明显长于普通支架组 [(2 4 7± 1 0 7)mmvs(1 7 2± 9 6 )mm ,P <0 0 1 ]。介入治疗后一个月随访结果示 ,心血管事件发生率 (MACE)、支架内血栓发生率两组间比较差异无统计学意义。介入治疗后 6个月随访结果显示 ,和普通支架组相比较 ,药物支架组有较低的再狭窄率和较少的心血管事件发生率 (分别为 1 8%vs 1 1 5 %,2 7%vs 8 0 %,P <0 0 1 )。
Objective To investigate the feasibility, safety and efficacy of Cypher TMdrug-eluting stent implantation in patients with unstable angina pectoris (UAP) treated by percutaneous coronary intervention (PCI). Methods 113 patients with UAP had been treated with Cypher TMdrug-eluting stent(DES)and were compared with a control group composed of 113 patients treated with bare stent in the same time. The incidence of major adverse cardiovascular event (MACE) and restenosis was evaluated. Results 226 patients were successfully treated by PCI. Compared with the control group, the DES group included more patients with diabetes (24.8% vs 11.3%, P<0.01) and more B2/C type lesion (55.4% vs 37.4%, P<0.01). The mean diameter of Cypher TMstent was less than that of the standard stent [(2.7±0.4)mm vs (3.2±0.3)mm, P<0.01] and the mean length of Cypher TMstent was more longer than that of the standard stent [(24.7±10.7)mm vs (17.2±9.6)mm, P<0.01]. There was no significant difference between the two groups in MACE rate and stent thrombosis rate 30 days later. At six months follow-up, there were less restenosis rate and MACE rate in the DES group than in the control group (1.8% vs 11.5%, 2.7% vs 8.0%, P<0.01). Conclusion Implanting Cypher TMdrug-eiuting stent in UAP patients during PCI was as safe and effective as that of bare stent. Compared with bare stent, Cypher TMdrug-eiuting stent can reduce restenosis rate and MACE in UAP patients treated with PCI.
出处
《中国介入心脏病学杂志》
2005年第1期13-16,共4页
Chinese Journal of Interventional Cardiology
