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目的观察冠状动脉内雷帕霉素洗脱支架扩张程度对内膜增生的影响。方法对2002年4月至2005年3月73例冠心病患者置入雷帕霉素洗脱支架后8个月利用血管内超声测定支架近端、支架远端和支架内管腔最小处血管段外弹力膜(EEM)横截面积(CSA)、支架内CSA、管腔CSA、新生内膜面积、支架最大直径及最小直径,并推算支架对称指数。利用最小支架CSA与同一部位EEMCSA比值、最小支架CSA与支架两端CSA平均值比值、最小支架CSA和最小支架CSA处支架对称指数来判断支架扩张程度,并观察支架扩张程度对内膜增生的作用。结果最小支架CSA/EEMCSA<0·5(n=56)与最小支架CSA/EEMCSA≥0·5(n=20)、最小支架CSA/支架两端CSA平均值<0·9(n=44)与最小支架CSA/支架两端CSA平均值≥0·9(n=32)、最小支架CSA<5mm2(n=25)与最小支架CSA≥5mm2(n=51)及对称指数<0·9(n=37)与对称指数≥0·9(n=39)患者比较内膜增生差异无统计学意义。结论雷帕霉素洗脱支架高压释放后支架扩张不全对支架内内膜增生没有影响。
Objective To observe the effect of rapamycin-eluting stent expansion on intimal hyperplasia in coronary artery. Methods From April 2002 to March 2005, 73 patients with coronary heart disease were treated with rapamycin-eluting stent 8 months after the endovascular stent implantation. The proximal end of the stent, the distal end of the stent, (EEM) cross-sectional area (CSA), stent CSA, lumen CSA, neointimal area, stent maximum diameter and minimum diameter, and calculate the stent symmetry index. The ratio of stent CSA to the same site EEMCSA, the average CSA ratio between the smallest stent CSA and the stent at both ends, the smallest stent CSA and the stent symmetry index at the smallest stent CSA were used to judge the degree of stent dilatation and the effect of stent dilatation on intimal hyperplasia . Results The minimum stent CSA / EEMCSA <0.5 (n = 56) and the minimum stent CSA / EEMCSA≥0.5 (n = 20) (N = 32), CSA <5mm2 (n = 25) and CSA≥5mm2 (n = 51) and symmetry index <0.9 (min = There was no significant difference in intimal hyperplasia between n = 37 and symmetry index ≥0.9 (n = 39). Conclusions Insufficient stent dilation after rapamycin eluting stent has no effect on intimal hyperplasia.