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作 者:朱汉华[1] 阳维德[1] 郑萍[1] 黄晓明[1] 布桂林[2] 苗颖[2] 马小燕[3] 罗秀峰[1] 陈锋[1] 谈礼武[1]
机构地区:[1]广西壮族自治区南溪山医院心内科,541002 [2]广西壮族自治区南溪山医院影像科,541002 [3]广西壮族自治区南溪山医院检验科,541002
出 处:《实用医学杂志》2017年第17期2877-2880,共4页The Journal of Practical Medicine
基 金:广西医疗卫生重点科研课题(编号:重2011020)
摘 要:目的探讨药物洗脱支架联合标准药物治疗与单纯标准药物治疗对冠状动脉临界病变合并易损斑块干预的临床预后研究。方法连续入选2011年7月至2016年1月住院的冠状动脉临界病变合并易损斑块患者327例,临界病变指冠脉造影50%<冠脉直径狭窄<70%,64排冠脉CT检测易损斑块。随机分为药物洗脱支架联合标准药物治疗组(支架组)与单纯标准药物治疗组(药物组),随访1年内主要心脏不良事件MACE(死亡、心梗、靶血管再次血运重建)。结果支架组成功随访160例,5例出现MACE;药物组成功随访160例,16例出现MACE,支架组较药物组MACE减少,差异具有统计学意义(3.13%vs.10%,log-rank检验χ~2=6.62,P=0.01);支架组较药物组死亡、心梗减少,差异具有统计学意义(1.25%vs.5.63%,log-rank检验χ~2=4.61,P=0.03)。结论对于冠状动脉临界病变合并易损斑块的处理策略,药物洗脱支架联合标准药物治疗较单纯标准药物治疗可以减少MACE。Objective To evaluate the one-year clinical outcomes in patients with the vulnerable plaque sealing with drug-eluting stents for the treatment of intermediate coronary stenosis. Methods 327 patients with angiographically intermediate lesions (diameter stenosis 50% - 70% ) with the vulnerable plaque which were detected by 64 slice coronary CT were prospectively enrolled. Patients were divided into medical therapy group (n = 160) and sirolimus-eluting stent group group (n = 160). The incidences of one-year major adverse cardiovascular events (MACE) was evaluated (cardiac death, myocardial infarction , revascularization). Results The MACE tended to be lower in the sirolimus-eluting stent group than medical therapy group (3.13% vs. 10%, log-rank χ^2 = 6.62, P = 0.01 ). The incident of cardiac death and myocardial infarction were lower in the sirolimus-eluting stent group than medical therapy group ( 1.25% vs. 5.63%, log-rank χ^2 = 4.61, P = 0.03 ). Conclusion The treatment of the sirolimus-eluting stent can reduce MACE for the paitents with the vulnerable plaque of intermediate coronary stenosis than medical therapy only.
关 键 词:药物洗脱支架 临界病变 主要心脏不良事件 易损斑块
分 类 号:R541.4[医药卫生—心血管疾病]
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