不同年代经皮冠状动脉治疗冠心病的临床比较  

Clinical and angiographic characteristics of patients underwent PCI in the era before and after drug-eluting stents

作　　者：康俊萍[1] 吕强[1] 聂绍平[1] 杜昕[1] 胡荣[1] 张崟[1] 贺立群[1] 高迎春[1] 刘新民[1] 董建增[1] 吴学思[1] 刘小慧[1] 马长生[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科,北京100029

出　　处：《中国医师杂志》2006年第11期1453-1455,共3页Journal of Chinese Physician

摘　　要：目的比较非药物涂层支架（non—DES）年代和DES年代接受经皮冠脉介入治疗（PCI）患者的临床及病变特征和介入治疗情况：方法DESIRE注册研究（Drug—Eluting Stent Impacton REvascularization）为单中心回顾性研究．入选了两个不同时间段即非DES年代（2001年7月～2002年6月）及DES年代（2003年7月～2004年6月）接受血运重建治疗的3763例患者，记录患者临床、血清学、药物治疗、冠脉病变特征及介入治疗情况，比较两个不同年代接受PCI患者的临床、冠脉病变特征和介入治疗情况。结果非DES年代组763例，DES年代组1417例。与非DES年代组相比，DES年代组PCI术中处理血管支数（1．31±0．54比1．39±0．61，P〈0．001）、病变个数（1．57±0．90比1．77±1．05，P〈0．001）和植入支架数（1.52±0．88比1．71±1．03，P〈0．001）均多于非DES年代组。2组PCI操作成功率差异无统计学意义。DES年代组处理左主干病变（1．6％比3．3％．P=0．017）、弥漫病变（11．4％比19．6％，P〈0．001）和多支病变（52．3％比56．8％，P=0．046）的比例高于非DES年代组，2组院内不良心脏事件分别为1．2％和0．9％，差异无统计学意义：结论与非DES年代相比，DES年代较多的左主干病变、多支病变和弥漫病变行PCI治疗，植入的支架数增加，但院内不良事件发生率并未增加。Objective To elucidate the clinical characteristics and coronary angiographic findings of patients underwent PCI before and after drug-eluting stents （DES）. Methods DESIRE （ Drug-Eluting Stent Impact on revascularization） was a retrospective registry of patients who received revascularization therapy during July, 2001 through June, 2002 （ non-DES era） and July, 2003 through February, 2004 （DES era）. In this analysis, we used the DISIRE data to examine the clinical and angiographic features of patients who received PCI in the different era. Results Among 3763 patients in the registry., 2180 patients were analyzed （763 were in the non-DES era and 1417 were in the DES era）. In the DES era, more diseased vessels （ 1.31 ± 0. 54 vs 1.39 ± 0. 61, P 〈 0. 001 ） and more lesions （ 1.57 ± 0.90 vs 1.77 ± 1.05, P 〈 0. 001 ） were treated and more stents （ 1.52±0. 88 vs 1.71 ± 1.03, P 〈 0. 001 ） were planted. The patients received PCI in the DES era were more likely to have left main coronary, artery disease （3.3% vs 1.6% , P =0. 017） , multivessel disease （two- and three-vessel disease in 56. 8% vs 52.3% , respectively, P =0. 046） and diffuse lesions（ 19. 6% vs 11.4% , P 〈0. 001 ）. The success rates of the operations were similar in different eras. There was no statistical significance in inhospital main cardiac events （0.9% vs, 1.2%. P =0. 556）. Conclusion In the DES era, more patients with left main coronary, artery disease , diffuse lesions and muhivessel disease received PCI, and more stents were planted . However, there was no increase in the MACE rate.

关 键 词：血管成形术 经腔 经皮冠状动脉/方法 冠状动脉疾病 

分 类 号：R541.4[医药卫生—心血管疾病]