西罗莫司洗脱支架与裸金属支架治疗冠心病多支病变的远期安全性比较  

Comparison of Long-Term Safety of Coronary Sirolimus-Eluting Stent with Bare Metal stent implantation in patients with multivessel coronary disease

作　　者：高迎春[1] 马长生[1] 聂绍平[1] 杜昕[1] 吕强[1] 张崟[1] 康俊平[1] 刘新民[1] 贺立群[1] 阙斌[1] 董建增[1] 刘晓慧[1] 吴学思[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科,内蒙古自治区医院心内科100029

出　　处：《中国介入心脏病学杂志》2008年第2期70-72,共3页Chinese Journal of Interventional Cardiology

摘　　要：目的观察多支冠状动脉病变使用西罗莫司洗脱支架行血运重建的远期临床安全性。方法单中心回顾性病历复习,入选冠状动脉造影显示2支、3支冠状动脉病变或左主干病变的患者562例。根据置入支架的不同,分为药物洗脱支架(SES)组(251例)、裸金属支架(BMS)组(311例)。对两组患者出院后死亡和AMI事件进行随访分析。结果中位随访时间为19.4个月,随访率92.9%。血运重建1年后心性死亡SES组3例,BMS组1例;非致死性心肌梗死每组2例。上述事件的发生率两组间差异无统计学意义(2.3%比1.1%,P=NS)。Kaplan-Meier方法分析显示,出院后无心性死亡和非致死性心肌梗死事件生存率两组间差异无统计学意义(97.3%比97.2%,P=0.951)。结论研究显示,多支冠状动脉病变西罗莫司洗脱支架置入治疗与裸金属支架比较,远期心性死亡和AMI事件的发生率相似,提示远期支架内血栓形成率不增加。Objective To observe the long-term safety of revascularization with sirolimus-eluting stent in patients with muhivessel coronary disease compared with bare metal stents. The study was a single center retrospective study. Methods Five hundred and sixty two patients with two- or three-vessel disease, or left main coronary artery disease who underwent revascularization were included and divided into two groups： the SES （n = 251 ） and the BMS （n = 311 ） group, according to the type of the stents implanted. The clinical end points were death and myocardial infarction one year later after stents implantation. Results Clinical follow up was accomplished in 92. 9% of the patients and the median time of follow-up was 19.4 months. One year after stents implantation, 3 patients died of cardiac causes in the SES group and 1 patient died in the BMS group. Myocardial infarction occured in 2 patients in each group. There was no significant difference in cardiac event rate between the 2 groups （2.3% versus 1.1%, P = NS）. No significant difference was found in cardiac death and nonfatal myocardial infarction event free survival rates estimated by Kaplan-Meier method between the two groups （97.3% versus 97.2%, P = 0. 951 ）. Conclusion One-year cardiac mortality and the incidence of myocardial infarction after SES implantation in patients with muhivessel disease were similar to those after BMS implantation which may suggest that late stent thrombosis does not increase with SES.

关 键 词：冠状动脉疾病 支架 冠状动脉血栓形成 

分 类 号：R541.4[医药卫生—心血管疾病] R730.55[医药卫生—内科学]