三氧化二砷洗脱支架与雷帕霉素药物洗脱支架在急性ST段抬高型心肌梗死中应用效果的比较  

Comparison of arsenic trioxide eluting stent with sirolimus eluting stent in acute ST-segment elevation myocardial infarction

作　　者：解梦诗 施鸿毓[1] 廖敏蕾 高明喜 陈晖[2] 仇兴标 戴锦杰 曲新凯 关绍峰 韩文正 干倩 XIE Mengshi;SHI Hongyu;LIAO Minlei;GAO Mingxi;CHEN Hui;QIU Xingbiao;DAI Jinjie;QU Xinkai;GUAN Shaofeng;HAN Wenzheng;GAN Qian(Department of Cardiology,Shanghai Baoshan District Wusong Central Hospital,Shanghai 200940,China;不详)

机构地区：[1]上海市宝山区吴淞中心医院(复旦大学附属中山医院吴淞医院)心血管内科,上海200940 [2]上海交通大学医学院附属胸科医院心血管内科 [3]复旦大学附属华东医院心血管内科

出　　处：《上海医学》2022年第9期619-622,共4页Shanghai Medical Journal

基　　金：上海市卫生健康委员会科研课题(202040368)。

摘　　要：目的评价直接经皮冠状动脉介入治疗(PPCI)中,三氧化二砷洗脱支架(AES)与雷帕霉素药物洗脱支架(SES)的安全性和有效性。方法选择2015年1月-2016年1月在上海市宝山区吴淞中心医院接受PPCI、年龄≥18岁的急性ST段抬高型心肌梗死(STEMI)患者100例,术中按照1∶1的比例将患者随机纳入AES组、SES组,每组50例。记录并比较两组患者的基线特征、心功能情况、实验室指标、病变血管情况、植入支架情况、手术情况、术后血流情况,以及术后住院期间及术后12个月内主要心血管不良事件(MACE)发生情况。结果两组间患者脑钠肽(BNP)、肌钙蛋白I(TNI)、肌酸激酶同工酶(CKMB)水平,以及心功能分级、左心室射血分数(LVEF)的差异均无统计学意义(P值均>0.05)。AES组术前心肌梗死溶栓治疗(TIMI)血流分级0级、行血栓抽吸的患者比例均显著高于SES组(P值均<0.01),两组间病变血管数量、梗死相关动脉、植入支架数量、支架直径、支架长度,以及术后血流TIMI 3级的患者比例的差异均无统计学意义(P值均>0.05)。AES组、SES组住院期间MACE发生率分别为4.0%(2/50)、2.1%(1/48),两组间的差异无统计学意义(P>0.05);术后12个月随访时MACE发生率分别为8.3%(4/48)、10.9%(5/46),两组间的差异亦无统计学意义(P>0.05)。结论AES与SES在急性STEMI中的应用效果相当。Objective To evaluate the safety and effectiveness of arsenic trioxide eluting stent(AES)versus sirolimus eluting stent(SES)in the primary percutaneous coronary intervention(PPCI).Methods One hundred patients aged over 18 years with acute ST-segment elevation myocardial infarction(STEMI)who received the PPCI at Shanghai Baoshan District Wusong Central Hospital from January 2015 to January 2016 were randomized into AES group and SES group in the ratio of 1∶1 during the operation(n=50).The baseline information,cardiac function,laboratory indexes,vascular lesions,stent implantation,surgical situation,postoperative bleeding,and major adverse cardiovascular events(MACE)were compared between the two groups.Results There were no significant differences in the brain natriuretic peptide(BNP),troponin I(TNI),creatine kinase isoenzyme(CKMB),cardiac functional grading,or left ventricular ejection fraction(LVEF)between the two groups(all P>0.05).The proportions of patients with preoperative thrombolysis in myocardial infarction(TIMI)level 0 and thrombus aspiration in the AES group were significantly higher than those in the SES group(both P<0.01).There were no significant differences in the number of diseased vessels,infarct-related arteries or implanted stents,stent diameter,or stent length,the proportion of patients with postoperative TIMI level 3 between the two groups(all P>0.05).The occurrence rate of MACE was 4.0%(2/50)in the AES group and 2.1%(1/48)in the SES during hospitalization(P>0.05).The occurrence rate of MACE was 8.3%(4/48)in the AES group and 10.9%(5/46)in the SES group at 12 months after surgery(P>0.05).Conclusion The result of this small-sample single-center study indicates that AES is comparable to SES in both hospitalization and short-term postoperative follow-up.It is essential to take multi-center studies to explore the long-term efficacy of AES in STEMI.

关 键 词：三氧化二砷洗脱支架 雷帕霉素药物洗脱支架 急性ST段抬高型心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病]