摘要
目的 观察在真实临床条件(realworld)下使用西罗莫司(雷帕霉素)药物CypherTM 支架的疗效。方法 入选我科自2 0 0 2年1 2月至2 0 0 4年5月所有应用CypherTM 支架的患者,共2 6 3例,于支架置入后8±2个月,电话及门诊随访应用药物洗脱支架患者的主要不良心脏事件发生率;评价糖尿病亚组及各种类型病变(包括左主干病变、分叉病变、慢性闭塞病变、钙化病变、开口病变、小血管病变、急性闭塞病变及再狭窄病变)的治疗效果。结果 2 6 3例患者支架置入成功率为1 0 0 % ;随访2 4 6例,失访1 7例,随访率93 5% ;主要不良心脏事件有1 0例,发生率为3 8% ;复查冠状动脉造影1 39例,支架内再狭窄率为1 0 1 % ,其中糖尿病亚组为1 2 . 9% ,弥漫病变为1 0 . 0 % ,开口病变6 9% ,慢性闭塞病变1 1 . 1 % ,小血管病变1 1 . 3% ,急性闭塞病变0 ,钙化病变9 1 % ,A型病变8 7% ,左主干病变2 2 . 2 % ,分叉病变1 8 .8% ,再狭窄病变1 1 . 1 %。结论 在真实临床状态下,CypherTM 支架可以明显减少糖尿病患者弥漫病变,急、慢性闭塞病变,小血管病变,开口病变,钙化病变,A型病变等主要不良心脏事件的发生。对于左主干病变、分叉病变和再狭窄病变,提示有益的疗效,临床疗效需进一步观察。
Objective To sbserve the effect of sirolimus-eluting stent in actual clinical practice. Methods The study included 263 patients who had implanted the cypher stents from December 2002 to May 2004. The incidence of MACE was followed up in all patients 8±2 months after stent implantation by means of telephone or out-patient department visit. Evaluation of the therapeutic effect was also made in the diabetes subgroup and different types of lesions, including left main, bifurcation, chronic total occlusion, diffuse disease, in-stent restenosis, littlie vessel, acute occlusion, ostial lesions, and just A-type lesions. The rate of restenosis was observed in all of the lesion. Results Among 246 patients, all patients were successfully implanted with the cypher stents, 93.5% patients had been followed up, 10 (3.8%) patients had MACE. 139 (52.6%) patient were revised by angiography. The total rate of restenosis was 10.1%, and among it 12.9% was diabetes mellitus patients, 11.1% with chronic total occlusion, 11.3% with little vessel lesion, 10.0% with diffuse lesion, 22.2% with left main lesion, 18.1% with bifurcation, 11.1 with CTO 9.1% with ostial lesions, and 8.7% with A-type lesion lesion. Conclusion Cypher stent implantion was safe and effective in actual clinical proctice. The incidence rate of MACE was low in lesions such as chronic total occlusion, diffuse disease, in-stent restenosis, littlie vessel, acute occlusion, ostial lesions, and A-type lesion. It may be beneficial for patients who had left main, bifurcation, in-stent restenosis.
出处
《中国介入心脏病学杂志》
2005年第2期67-70,共4页
Chinese Journal of Interventional Cardiology
