摘要
目的 研究3 2 P冠状动脉内放射治疗预防冠状动脉支架术后再狭窄的疗效及其剂 效关系。方法 对成功进行冠状动脉内支架成形术的 3 0例患者 ,将不同剂量的3 2 P放射源经 5F管推送入冠状动脉支架术部位 ,进行不同剂量与时间的放射治疗。在放射治疗前、结束时和随访 6个月后分别进行冠状动脉造影和血管内超声检查。结果 定量冠状动脉造影显示 ,3 0例支架置入全部成功。全组随访 6个月平均后期管腔缩减径为 ( 0 0 3± 0 53 )mm ,缩减指数为 0 0 9± 0 51。血管内超声显示 ,放射治疗结束时和治疗后 6个月 ,全组血管内膜厚分别为 (1 0 3± 0 16)mm和 (1 12± 0 2 1)mm(P >0 0 5) ;血管壁面积分别为 (8 3 3± 2 16)mm2 和 (8 0 6± 3 12 )mm2 (P >0 0 5)。放射治疗完成时和治疗后 6个月 ,EEM面积和MLD面积的累积百分比曲线较术前显著右移 ,且治疗后 6个月时的10、15和 2 0GY三剂量级EEM面积和MLD面积的累积百分比曲线相似。经对数回归分析 ,时程剂量与MLD面积间无相关关系 (n =3 0 ,r =0 3 65894,P >0 50 )。结论 冠状动脉内3 2 P放射治疗能有效预防支架置入后冠状动脉再狭窄 ;10GY放射治疗 150s是其“最适剂量”。
Objective To study on the dose-efficacy relations and effects of inhibiting neointima formation and preventing restenosis of coronary with intracoronary 32 P irradiative therapy after coronary angioplasty Methods Through a 5F catheter a 32 P source train was delivered to native coronary arteries after s uccessful brachytherapy in 30 patients Quantitative coronary angiography and intravascular ultrasound (IVUS) were performed before operation, at procedure finished and 6-month follow-up Results Quantitative coronary angiography showed that no restenosis was present in 30 patients Angiographic late loss was -0 03±0 53 mm, with a -0 09±0 51 loss index IVUS demonstrated significantly removed to right at minimal lumen area cumulative percentage curve and external elastic membrane area cumulative percentage curve, which was associated with similar positions and shapes in 10Gy, 15Gy and 20Gy dose-class Wall area was 9 68±4 35 mm 2, endangi um was 1 03±0 16 mm after radiation therapy Over the 6-month follow-up, wall area was 8 10±3 24 mm 2, endangium was 1 12±0 21 mm The logarithm regression an alysis showed that no correlation(n=30,r=0 365 894, P>0 50) between minimal lumen area and time-dose was found Conclusions 32 P irradiative therapy could effectively prevent coronary restenosis after coronary angioplasty with 10Gy/150s which might be'the best selection' for irradiative dose and time
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2003年第8期581-583,共3页
Chinese Journal of Cardiology
基金
广东省卫生厅自然科学基金资助项目( 1 1 1 92 4 )
