论文部分内容阅读
目的比较国产西罗莫司洗脱支架(FBS)和进口紫杉醇洗脱支架(PES)治疗冠状动脉狭窄的效果。方法选择阜外心血管病医院2004年4月至2005年8月连续接受国产西罗莫司洗脱支架或紫杉醇洗脱支架治疗,并且进行冠状动脉造影随访的228例冠心病患者。排除支架置入失败、位置不理想者。所有的患者术后均接受阿司匹林300mg/d、氯吡格雷75mg/d等规范药物治疗。患者在支架术后6个月后接受冠状动脉造影随访。结果共228例患者(198名男性,30名女性)314个靶病变接受治疗并完成造影随访。其中C型病变占总数的40.1%,平均术前参考血管直径2.80±0.47mm。平均每个病变支架长度25.90±14.54mm。228例患者中118例置入紫杉醇洗脱支架,100例置入西罗莫司洗脱支架。两组在患者基本条件方面,国产西罗莫司洗脱支架组患者年龄大于紫杉醇洗脱支架组,紫杉醇洗脱支架组有更多的2型糖尿患者;在病变基本条件方面,国产西罗莫司洗脱支架组病变更多偏心性病变,其他没有差别。6个月后随访结果国产西罗莫司洗脱支架组的支架再狭窄率明显低于紫杉醇洗脱支架组(5.3%比21.9%,P<0.001)。国产西罗莫司洗脱支架组的靶病变血管重建率(TLR)明显低于紫杉醇洗脱支架组(3.8%比13.1%,P<0.001)。国产西罗莫司洗脱支架组支架内晚期腔径丢失明显小于紫杉醇洗脱支架组(0.18±0.41mm比0.58±0.69mm,P<0.001)。结论国产西罗莫司涂层支架用于临床实践有良好的疗效。
Objective To compare the effects of domestic sirolimus-eluting stent (FBS) and imported paclitaxel-eluting stent (PES) in the treatment of coronary artery stenosis. Methods Fu Wai Hospital from April 2004 to August 2005 were continuously treated with domestic sirolimus-eluting stent or paclitaxel-eluting stent treatment, and coronary angiography follow-up of 228 patients with coronary heart disease. Exclude stent placement failed, the location is not ideal. All patients received aspirin 300mg / d, clopidogrel 75mg / d and other standard drug treatment. Patients were followed up for coronary angiography 6 months after stenting. Results A total of 228 patients (198 males and 30 females) received 314 target lesions and completed angiographic follow-up. Type C lesions accounted for 40.1% of the total, the average preoperative reference vascular diameter 2.80 ± 0.47mm. The average length of each stent was 25.90 ± 14.54mm. Of the 228 patients, 118 received paclitaxel-eluting stents and 100 received sirolimus-eluting stents. In terms of patient’s basic condition, patients in the domestic sirolimus-eluting stent group were older than those in the paclitaxel-eluting stent group and paclitaxel-eluting stent group with more type 2 diabetes patients. In the basic condition of the disease, the domestic sirolimus Secretary elution stent group more eccentric lesions, the other no difference. After 6 months of follow-up, the stent restenosis rate of the domestic sirolimus-eluting stent group was significantly lower than that of the paclitaxel-eluting stent group (5.3% vs 21.9%, P <0.001). The target lesion revascularization rate (TLR) of the domestic sirolimus-eluting stent group was significantly lower than that of the paclitaxel-eluting stent group (3.8% vs 13.1%, P <0.001). The loss of late luminal diameter in the stent produced by the domestic sirolimus-eluting stent group was significantly smaller than that of the paclitaxel-eluting stent group (0.18 ± 0.41mm vs. 0.58 ± 0.69mm, P <0.001). Conclusion Domestic sirolimus-coated stents have good curative effect in clinical practice.