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目的探讨混合置入药物洗脱支架和裸金属支架治疗多支冠状动脉病变的远期疗效和安全性。方法选取2011年2月—2015年7月新疆石河子大学医学院第一附属医院收治的多支冠状动脉病变患者498例,均行经皮冠状动脉支架置入术,其中行混合置入药物洗脱支架和裸金属支架患者214例作为观察组,行单纯置入裸金属支架患者284例作为对照组。比较两组患者手术情况和随访情况。结果两组患者支架置入数、靶病变分型、支架长度、支架内径、置入后扩张率、支架间重叠率、经皮冠状动脉介入治疗(PCI)成功率、术后最终残余狭窄率及平均支架置入数比较,差异无统计学意义(P>0.05);观察组患者最高支架扩张压力高于对照组(P<0.05)。对照组、观察组完成随访的患者数分别为259、196例。在完成随访的患者中,观察组患者再狭窄率、再次血运重建率、并发症发生率、不良心血管事件发生率均低于对照组(P<0.05)。结论混合置入药物洗脱支架和裸金属支架可降低多支冠状动脉病变患者再狭窄发生率,减少并发症和不良心血管事件的发生,远期疗效较好且安全性较高。
Objective To investigate the long-term efficacy and safety of mixed drug-eluting stents and bare metal stents in the treatment of multiple coronary lesions. Methods From February 2011 to July 2015, 498 patients with multi-vessel coronary artery disease were admitted to the First Affiliated Hospital of Shihezi University School of Medicine in Xinjiang. All patients underwent percutaneous coronary stent implantation. The patients were treated with drug-eluting stent And bare metal stent patients 214 cases as the observation group, the simple metal stent implantation in 284 patients as a control group. The operation and follow-up of the two groups were compared. Results The number of stent implantation, the type of target lesion, the length of stent, the diameter of stent, the rate of stent dilation after stent implantation, the overlap rate between stent, the success rate of percutaneous coronary intervention (PCI), the final residual stenosis rate There was no significant difference between the two groups (P> 0.05). The highest stent dilatation pressure in the observation group was higher than that in the control group (P <0.05). The number of patients who completed the follow-up in the control group and observation group were 259,196 cases respectively. Among the patients who completed follow-up, the restenosis rate, rate of revascularization, complication rate and incidence of adverse cardiovascular events in observation group were lower than those in control group (P <0.05). Conclusion The combination of drug-eluting stent and bare metal stent can reduce the incidence of restenosis and reduce the incidence of complications and adverse cardiovascular events in patients with multivessel coronary artery disease. The long-term effect is better and the safety is better.