摘要
目的:观察不同支架植入方式对小血管(血管直径≤2.75 mm)支架内再狭窄的影响。方法:对69(男51,女18)例患者共111处病变进行治疗,实验组(n=38)直接植入支架64枚(雷帕霉素药物洗脱支架53枚,紫杉醇药物洗脱支架11枚),对照组(n=31)预扩张后植入支架47枚(雷帕霉素药物洗脱支架41枚,紫杉醇药物洗脱支架6枚),两组患者术后即刻行冠脉血管内超声(IVUS)检测最小支架直径及横截面积。术后有胸闷胸痛症状患者即刻行冠脉造影术及IVUS,无症状患者6个月后复查。通过IVUS检测,对两组管腔丢失及支架内再狭窄率进行比较。结果:两组支架植入术后即刻最小支架直径实验组为(2.38±0.26)mm,对照组为(2.34±0.24)mm(P>0.05);支架横截面积实验组为(4.5±1.0)mm2,对照组为(4.3±0.9)mm2(P>0.05);6个月随访后复查两组管腔丢失,实验组为(1.44±0.30)mm,对照组为(0.98±0.24)mm(P=0.01);支架内再狭窄发生率实验组为15%;对照组为30%(P<0.05)。结论:对冠状动脉小血管病变患者直接药物洗脱支架植入组支架内再狭窄发生率低于预扩张后支架植入组。
AIM： To investigate the effects of different implantation modes of drug-eluting stents upon restenosis of small vessel lesions（diameter ≤2.75 mm）.METHODS： Sixty-nine patients（51 males and 18 females） with 111 lesions were enrolled after implanting drug-eluting stents.The experimental group consisted of direct implantation of drug-eluting stents and the 64 stents included 53 rapamycin and 11 paclitaxel drug-eluting stents.The control group consisted of implanted drug-eluting stents after balloon predilation and the 47 stents included 41 rapamycin and six paclitaxel drug-eluting stents.After procedures,coronary angiography and intravascular ultrasound（IVUS） were performed immediately in case of chest pain.For those without chest pain,coronary angiography and IVUS were performed after 6 months.In-stent restenosis was detected by IVUS and the rates of in-stent restenosis were compared between groups.RESULTS： The average diameters of small vessels immediately evaluated postoperatively in experimental group and control group were,respectively（2.38±0.26） mm and（2.34±0.24） mm（P0.05）.The average cross-sectional areas of lumens of small vessels in experimental group and control group were,respectively,（0.26±0.30） mm2 and（4.3±0.9） mm2（P0.05）.However,6 months postoperatively,the loss of lumens in experimental group and control group were（1.44±0.30） mm and（0.98±0.24） mm,respectively（P=0.01） and the ratios of in-stent restenosis were 14.60% and 29.78%,respectively（P0.05）.CONCLUSION： For patients with small vessel lesions,direct implantation of drug-eluting stents is superior to implanting drug-eluting stents after balloon predilation.
出处
《心脏杂志》
CAS
2011年第6期786-789,共4页
Chinese Heart Journal
关键词
小血管
支架植入
预扩张
再狭窄
small vessel
implantation
drug-eluting stent
balloon predilation： in-stent restenosis
