EXCEL与PARTNER支架单一植入治疗急性ST段抬高型心肌梗死长期临床应用的安全性和有效性研究  

The long-term safety and efficacy of EXCEL and PARTNER in the treatment of acute ST-segment elevation myocardial infarction

作　　者：王琳[1] 曲鹏[1] 娄大元[1] 牛楠[1] 王虹艳[1] 袁大军[1] 丁彦春[1] 王纪文[1] Aswinee Kumar Karooa M.Fazil Moussa Rikesh Dayal 李雪梅[2] 郑英花[1] 张鸿[2] 

机构地区：[1]大连医科大学附属第二医院心内科,116023 [2]大连医科大学附属第二医院导管室,116023

出　　处：《实用医学杂志》2013年第11期1764-1767,共4页The Journal of Practical Medicine

摘　　要：目的:比较EXCEL与PARTNER支架单一植入治疗急性ST段抬高型心肌梗死(STEMI)的长期有效性和安全性。方法:328例入选患者,分为EXCEL组(175例)与PARTNER组(153例),行PCI治疗并单一植入EXCEL或PARTNER支架。随访12～70个月观察两组MACE的发生率及两组生存时间。结果:两组间MACE发生率及心源性死亡、非致命性心肌梗死、TVR的发生率无统计学差异。两组间生存时间:EXCEL组:(58.77±1.51)个月;PARTNER组:(61.92±1.57)个月;两组生存时间比较,t=0.074,P=0.78。结论:国产生物可降解涂层与不可降解涂层药物支架在急性STEMI PCI治疗中有相似的安全性和有效性。在长期的临床随访中,心源性死亡、非致命性心肌梗死和靶血管血运重建以及MACE的发生率无显著差异。但本研究发现,术后很长时间(>59个月)内,EXCEL药物洗脱支架患者的生存率比PARTNER药物洗脱支架患者的生存率高,在冠心病真实世界中造成该现象可能与样本例数少有关,需要进一步进行多中心、更大样本的研究。Objective To compare the long-term efficacy and safety of EXCEL and PARTNER in the treatment of acute ST-segment elevation myocardial infarction （STEMI）. Methods All 328 patients were divided into EXCEL group （n = 175） and PARTNER group （n = 153）. Both groups were followed-up for a period of 12 - 70 months post-stenting. The primary end points were the incidence of MACE and the survival times. Results The incidence of MACE, cardiac death, non-fatal myocardial infarction and TVR had no significant difference between the two groups. The survival times of EXCEL group and PARTNER group were （58.77 ± 1.51 ） months and （61.92 ± 1.57） months （t = 0.074, P = 0.78）. Conclusion China-made biodegradable polymer drug-eluting stents （EXCEL） and non-biodegradable polymer drug-eluting stents （PARTNER） had similar safety and efficacy in STEMI treated by PCI. In long-term clinical follow-up, cardiac death, myocardial infarction, TVR and MACE incidence showed no significant difference. This study showed that in a long term （〉 59 months）, EXCEL group had a better survival rate, which may be connected with the less numbers of sample, and needed further multi-center, large sample research on coronary heart disease.

关 键 词：雷帕霉素 生物可降解涂层 经皮冠状动脉介入治疗 抗血小板 

分 类 号：R542.22[医药卫生—心血管疾病]