国产西罗莫司洗脱支架与裸支架治疗急性心肌梗死临床疗效的比较  

Comparison of effects between China made sirolimus-eluting stents and bare stents for treating patients with acute myocardial infarction

作　　者：金惠根[1] 刘宗军[1] 杨伟[1] 汪蔚青[1] 施佳[1] 王东毅[1] 汪志华[1] 于宏梅[1] 来莺[1] 沈峻[1] 方平[1] 

机构地区：[1]上海市普陀区中心医院心内科,200062

出　　处：《中华心血管病杂志》2007年第8期697-700,共4页Chinese Journal of Cardiology

基　　金：上海市医学重点专科资助项目(05-Ⅱ026)

摘　　要：目的探讨国产西罗莫司洗脱支架与裸支架治疗急性心肌梗死(AMI)临床疗效的差异。方法 173例连续行直接 PCI 的 AMI 患者随机分为西罗莫司洗脱支架组(87例)和裸支架组(86例),分析住院期间和支架置入后6个月的支架内血栓、主要心血管事件(包括再次心肌梗死、缺血性靶血管重建和死亡)发生率及6个月再狭窄率。结果两组患者在术后血管通畅、肌酸激酶峰值、心功能和住院期间心脏事件方面差异均无统计学意义(P>0.05)。两组各有2例支架内血栓(2.4%比2.3%,P>0.05)。6个月时,国产西罗莫司洗脱支架组的支架内再狭窄率(4.5%比40.0%,P<0.01)、节段内再狭窄率(6.8%比44.9%,P<0.01)和主要不良心脏事件发生率(8.0%比24.4%,P<0.01)显著低于裸支架组。国产西罗莫司洗脱支架组主要心脏事件的减少主要是因为缺血性靶血管重建减少所致(3.4%比11.6%,P<0.05)。结论与裸支架相比,国产西罗莫司洗脱支架治疗AMI 患者并未增加6个月内支架内血栓的发生,而显著降低6个月的再狭窄率和主要心脏事件发生率。Objective To compare the clinical outcomes between China made sirolimus-eluting stents （SES） and bare metal stents （BMS） implantation in patients with acute myocardial infarction （AMI）. Methods Consecutive patients with AMI underwent primary percutaneous coronary intervention （PCI） were randomly divided into SES group （n =87） and BMS group （n = 86）. The incidence of major adverse cardiac events （MACE including death, reinfarction, in-stent thrombosis, restenosis rate, target vessel revascularization） up to 6 months post PCI were assessed. Results Postprocedure vessel patency, enzymatic release, cardiac function, and the incidence of short-term MACE were similar between the two groups （all P 〉 0. 05）. Two in-stem thrombosis was diagnosed in the SES group and bare stems group respectively （2.4% vs. 2. 3%, P 〉0. 05）. At 6 months, In-stent restenosis rate （4. 5% vs. 40.0%, P 〈 0. 01） and the in-segment restenosis rate （6. 8% vs. 44. 9%, P 〈 0. 01 ） as well as MACE （ 8. 0% vs. 24.4%, P 〈0. 01 ）, which is mainly due to a marked reduction in the risk of target vessel revascularization （3.4% vs. 11.6%, P 〈 0.05 ） were significantly lower in SES group compared to BMS group. Conclusion The China made SES were not associated with an increased risk of in-stent thrombosis but significantly reduced restenosis rate and MACE at 6 months post primary angioplasty in patients with AMI.

关 键 词：心肌梗塞 血管成形术 经腔 经皮冠状动脉 支架 

分 类 号：R542.22[医药卫生—心血管疾病]