涂层可降解与不可降解西罗莫司洗脱支架在经皮冠状动脉介入治疗中的疗效和安全性  

Efficacy and safety of domestic biodegradable polymer sirolimus-eluting stents and durable polymer sirolimus-eluting stents in the treatment of coronary artery disease

作　　者：方毅[1] 王斌[1] 李晶[1] 裘淼涵 韩雅玲[1] 

机构地区：[1]沈阳军区总医院心血管内科,辽宁沈阳110016

出　　处：《中国介入心脏病学杂志》2017年第1期2-6,共5页Chinese Journal of Interventional Cardiology

基　　金：军队临床高新技术重大项目(2010gxjs001);辽宁省科技攻关项目(2013225089)

摘　　要：目的比较国产涂层可降解与涂层不可降解西罗莫司(雷帕霉素)洗脱支架(sirolimuseluting stents,SES)在冠心病患者行经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)中的有效性和安全性。方法选取2012年10月至2014年1月在沈阳军区总医院置入SES的冠心病患者2950例,其中涂层可降解SES组患者1520例,涂层不可降解SES组患者1430例。采用倾向评分配对分析对基线不匹配患者行1∶1匹配后得到倾向匹配队列,观察两组患者PCI术后主要不良心血管事件(major adverse clinical events,MACE,包括心源性死亡、非致死性心肌梗死、靶血管血运重建)和支架内血栓的发生率。结果随访1年,涂层可降解SES组和涂层不可降解SES组的MACE[85例(6.8%)比75例(6.0%),P=0.414]、心源性死亡[20例(1.6%)比18例(1.4%),P=0.744]、非致死性心肌梗死[28例(2.2%)比22例(1.8%),P=0.391]、靶血管血运重建[44例(3.5%)比36例(2.9%),P=0.363]、支架内血栓[14例(1.1%)比8例(0.6%),P=0.284]的发生率分别比较,差异均无统计学意义。结论国产涂层可降解与不可降解SES在冠状动脉疾病治疗中的近期疗效和安全性相似,其远期效果有待进一步研究。Objective To compare the efficacy and safety of domestic biodegradable polymer sirolimus-eluting stents and durable polymer sirolimus-eluting stents in interventional treatment of coronary heart disease. Methods A cohort of 2950 consecutive patients with coronary arterial disease who underwent drug eluting stents implantation was established. The patients were randomly divided into the biodegradable polymer group （ n = 1520 ） and the durable polymer group （ n = 1430 ）. Gender data was matched for correction by using propensity score matching method. The incidence of main adverse cardiac event（MACE） （including cardiac death, myocardial infarction and target vessel revascularization ） and stem thrombosis （ST） were followed up for one year. Results Two groups were similar in main baseline clinical information and major angiography characteristics after matching. The results showed that the two groups of patients resulting in cardiogenie death （ 1.6% vs. 1.4% ,P =0. 744）, myocardial infarction （2. 2% vs. 1.8% ,P = 0. 391） , target vessel revascularization （3.5% vs. 2. 9% ,P =0. 363） , overall MACE （6. 8% vs. 6. 0% , P=0.414） and stent thrombosis （1.1% vs. 0. 6%, P = 0. 284）were all of no significant difference respectively. Conclusions The recent efficacy and safety of domestic biodegradable polymer sirolimus- eluting stents and durable polymer sirolimus-eluting stents in the treatment of coronary artery disease are similar. The long-term effect needs further study.

关 键 词：药物洗脱支架 涂层可降解 涂层不可降解 西罗莫司 

分 类 号：R541.4[医药卫生—心血管疾病]