OCT观察PCI术后可降解及永久性聚合物药物涂层支架内新生内膜增生的差异  

Differences of biodegradable polymer drug-eluting stents versus permanent polymer drugeluting stents on neointimal hyperplasia from optical coherence tomography observations after percutaneous coronary intervention

作　　者：朱琳琳[1] 孟培娜 尤威[1] 吴志明[1] 叶飞[1] 谢渡江[1] ZHU Linlin;MENG Peina;YOU Wei;WU Zhiming;YE Fei;XIE Dujiang(Department of Cardiology,the Affiliated Nanjing Hospital of Nanjing Medical University(Nanjing First Hospital),Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)心血管内科,江苏南京210006

出　　处：《南京医科大学学报（自然科学版）》2021年第10期1474-1479,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：南京市医学科技发展项目(YKK17106)。

摘　　要：目的:通过光学相干断层显像(optical coherence tomography,OCT)观察经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后1年,聚合物可降解药物涂层支架(Firehawk)与永久性聚合物药物涂层支架(Xience系列)内新生内膜增生的差异,旨在观察可降解聚合物及永久性聚合物对支架内新生内膜增生的影响。方法:本研究为单中心、回顾性设计,入选2014年1月—2019年6月在南京市第一医院心内科行PCI术且术后1年有冠脉造影+OCT检查资料的患者;依据术中植入的药物涂层支架的不同类型分为Firehawk组和Xience组;比较两组临床基线资料、PCI术中参数及术后复查OCT的相关指标。结果:本研究共入选106例患者,其中Firehawk组52例,Xience组54例。两组患者的临床基线资料(包括年龄、性别、高血压病史、糖尿病史、吸烟史、血脂指标以及药物如阿司匹林、氯吡格雷/替格瑞洛、他汀、β受体阻滞剂、ACEI/ARB服用史)在PCI术前及术后1年差异无统计学意义(P>0.05);两组患者PCI术中参数(包括靶血管分布、支架直径及长度、预扩及后扩比例、最大预扩/后扩球囊直径、最大预扩/后扩压力)差异无统计学意义(P>0.05);术后1年复查OCT提示,两组患者的支架内增生情况(包括最大新生内膜厚度、最大新生内膜面积、最小管腔面积、最小管腔直径、再狭窄率、同质性比例)差异无统计学意义(P>0.05)。结论:聚合物可降解与永久性聚合物药物涂层支架植入术后1年,支架内新生内膜增生的性质特点类似。Objective:The aim of this study is to compare the effect of biodegradable polymer drug-eluting stents(Firehawk)versus permanent polymer drug-eluting stents(Xience)on neointimal hyperplasia at one-year follow-up after percutaneous coronary intervention(PCI)from optical coherence tomography(OCT)observations. Method:This was a retrospective single center study,patients who had Firehawk/Xience stents during PCI in our center from January 2014 to June 2019 were included in the trial,and they were divided into two groups:Firehawk group and Xience group. At one-year follow-up,we compared the difference of in-stent neointimal hyperplasia from OCT observations between the two groups. Results:Totally 106 patients were finally enrolled,including 52 patients who were in the Firehawk group and 54 who were in the Xience group. There were no differences of clinical characteristics before PCI and at one-year follow-up between the two groups(P >0.05). There were no differences of parameters during PCI(target vessel,diameter and length of stent,pre-dilation and post-dilation,maximum diameter/pressure of dilated-balloons)between the two groups(P >0.05). At one-year follow-up,in-stent neointimal hyperplasia(maximum neointimal thickness,maximum neointimal area,minimum luminal area,minimum luminal diameter,restenosis rates and percentage of homogeneous property)was also similar between the two groups(P >0.05). Conclusion:It is similar of vascular response to biodegradable polymer drug-eluting stents and permanent polymer drug-eluting stents at one-year follow-up.

关 键 词：光学相干断层显像 聚合物可降解药物涂层支架 永久性聚合物药物涂层支架 支架内增生 

分 类 号：R542.2[医药卫生—心血管疾病]