应用可吸收聚合物西罗莫司洗脱支架与耐用聚合物依维莫司洗脱支架治疗冠状动脉中重度钙化小血管病变的疗效分析  

Analysis of BP-SES and DP-EES for interventional treatment of small vessel lesions with moderate to severe calcification in coronary arteries and their short-term and long-term efficacy

作　　者：杨瑞金 肖扬 马涛 耿倩雯 张顺宗 郭佳佳 YANG Rui-jin;XIAO Yang;MA Tao;GENG Qian-wen;ZHANG Shun-zong;GUO Jia-jia(Department of Cardiology,Joint Logistic Support Force 987th Hospital,Baoji 721004,China)

机构地区：[1]联勤保障部队第987医院心内科,陕西省宝鸡市721004

出　　处：《中国心血管病研究》2021年第11期1006-1010,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的回顾性对比分析应用可吸收聚合物西罗莫司洗脱支架(BP-SES)与耐用聚合物依维莫司洗脱支架(DP-EES)治疗冠状动脉中重度钙化小血管病变近、远期疗效。方法选取2015年1~12月本院289例冠状动脉中重度钙化小血管病变接受经皮冠状动脉介入治疗(PCI)治疗的患者为研究对象。根据PCI术实际操作情况分为BP-SES组(共174例,置入BP-SES治疗)和DP-EES组(共115例,置入DP-EES治疗),统计两组病例的双联抗血小板药物应用时间,并以近期(1年随访)和远期(5年随访)的主要终点事件和次要终点事件为疗效观察指标。结果 BP-SES组的术后药物应用时间(6.78±1.71)个月低于DP-EES组(9.87±2.38)个月,差异具有统计学意义(t=19.921,P=0.000)。两组近期(1年随访)的主要终点事件(全部心肌梗死、全因死亡、全部血运重建)、次要终点事件(靶病变再次血运重建、非致死性心肌梗死、缺血性卒中)发生率比较,差异均无统计学意义(χ^(2)=0.074~0.389;P=0.384~0.922)。BP-SES组的远期(5年随访)的主要终点事件主要终点事件(全部心肌梗死、全因死亡、全部血运重建)、次要终点事件(靶病变再次血运重建、非致死性心肌梗死、缺血性卒中)发生率低于DP-EES组,差异具有统计学意义(χ^(2)=5.958~9.084;P=0.001,0.0036)。结论 BP-SES治疗冠状动脉中重度钙化小血管病变的远期临床效果优于DP-EES,并且能明显缩短术后双联抗血小板药物应用时间。Objective To compare the efficacy of bioresorbable polymer sirolimus-eluting stent(BP-SES and durable polymer everolimus-eluting stent(DP-EES) in interventional treatment of small vessel lesions with moderate to severe calcification in coronary arteries and the short-term and long-term efficacy. Methods A total of 289 patients with moderate and severe coronary calcifications undergoing percutaneous coronary intervention(PCI) were selected from January to December 2015. 174 cases were divided into BP-SES group and 115 cases into DP-EES group according to the operation. The duration of dual antiplatelet drug application was recorded and the primary and secondary end point events were observed in both groups in recent(1-year follow-up) and long(5-year follow-up) term. Results The duration of dual antiplatelet drug application in the BP-SES group(6.78±1.71)months was lower than DP-EES gruop(9.87±2.38) months and was statistically significant(t=19.921, P=0.000).The incidence of major endpoint events(total myocardial infarction, all-cause death, total revascularization) and secondary endpoint events(target revascularization, non-fatal myocardial infarction, ischemic stroke) were matched between the 2 groups and the difference was not statistically significant(χ^(2)=0.074~0.389;P=0.384~0.922). The primary endpoint events(total myocardial infarction, all-cause death, total revascularization),secondary endpoint events(target revascularization, non-fatal myocardial infarction, ischemic stroke) in the BPSES group were lower than those in the DP-EES group and the difference was statistically significant(χ^(2)=5.958~9.084;P=0.001, 0.0036). Conclusion BP-SES has a better long-term clinical effect than DP-EES in the treatment of moderate to severe calcified small vessel lesions in coronary arteries and can significantly shorten the application time of postoperative dual antiplatelet agents.

关 键 词：可吸收聚合物西罗莫司洗脱支架 耐用聚合物依维莫司洗脱支架 冠状动脉 钙化小血管病变 疗效 

分 类 号：R541.4[医药卫生—心血管疾病]