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目的:了解药物洗脱支架(DES)置入术的长期疗效。方法:收集255例DES置入及258例金属裸支架(BMS)置入患者的临床资料并进行长期临床随访,记录2组患者在随访时主要心血管不良事件(MACE)的发生情况。结果:与BMS组比较,DES组心绞痛再发率(6.27%∶17.05%,P<0.05)、MACE发生率(3.92%∶10.47%,P<0.05)及因心脏病住院率(5.29%∶15.19%,P<0.01)明显减少,而在晚期支架血栓形成、全因性死亡、非致死性心肌梗死及恶性肿瘤方面,2组相比差异无统计学意义。经校正了不匹配因素后发现应用BMS与心绞痛再发(r=0.084 9,P=0.048)、心因性死亡(r=0.098 2,P=0.027)、MACE(r=0.093 7,P=0.035)及因心脏病住院(r=0.090 8,P=0.041)的发生呈正相关。结论:与BMS相比,DES可减少心绞痛再发及MACE,而不增加晚期支架血栓形成及全因性死亡。
Objective: To understand the long-term efficacy of drug-eluting stent (DES) implantation. Methods: The clinical data of 255 patients with DES implantation and 258 patients with bare metal stent (BMS) were collected and were followed up for a long term. The incidence of major adverse cardiovascular events (MACE) at follow-up was recorded in both groups. Results: Compared with BMS group, the recurrence rate of angina (6.27%: 17.05%, P <0.05), MACE (3.92%: 10.47%, P <0.05) %, P <0.01). However, there was no significant difference between the two groups in late stent thrombosis, all-cause death, non-fatal myocardial infarction and malignant tumor. After adjusting for unmatched factors, it was found that there was no significant difference between the two groups in recurrence of angina pectoris (r = 0.084 9, P = 0.048), cardiac death (r = 0.098 2, P = 0.027) ) And hospitalization due to heart disease (r = 0.090 8, P = 0.041). Conclusion: Compared with BMS, DES can reduce recurrence of angina pectoris and MACE without increasing stent thrombosis and all-cause mortality.