不同种类冠状动脉药物洗脱支架混合使用87例临床研究

目的观察在同一冠心病患者体内混合使用不同种类的药物洗脱支架(DES)对长期预后的影响。方法2003年1月至2004年10月按先后顺序入选223例接受DES治疗的冠心病患者,将其中87例接受两种或两种以上DES者(Cypher,Firebird,Taxus)作为观察组,136例仅接受一种DES治疗者作为对照组,在支架手术后5~10个月进行冠状动脉造影随访,并观察冠心病临床事件的发生情况。结果观察组61例(70.1%)及对照组93例(68.4%)术后半年接受冠状动脉造影复查,再狭窄率分别为观察组(5例)8.2%及对照组(7例)7.5%(P>0.05)。随访发现临床事件总发生率分别是术后4周观察组4.6%及对照组3.7%,术后6个月8.6%及7.1%(P>0.05)。结论不同种类DES混合应用安全、有效,与对照组比较并不增加临床事件的发生率。

Clinical study of combined implantation of different kinds of drug eluting stents

Objective To investigate the effect of combined implantation of different kinds of DES on the prognosis of coronary heart disease patients. Methods 223 patients who were implanted with DES during January 2003 and October 2004 were enrolled in the study. Among them, 87 patients who had received more than one kind of DES were included as the observation group while the other 136 patients were taken as the control group. The incidence of MACE was followed up in all patients and possible CAG was carried out 5 to 10 months after stenting. Results In the observation group, 61 patients (70.1%) accepted coronary angiography and 93 (68.4%) patients received the procedure in the control group. The restenosis rates were 8.2% in the observation group and 7.5% in the control group respectively (P>0.05). The occurrence rate of major adverse cardiac events was 4.6% in the observation group and 3.7% in the control group after 4 weeks. At 6 months followed up, the incidence of MACE were 8.6% and 7.1% in the observation group and the control group respectively (P>0.05). Conclusion Combined inplantation of different types of DES is safe and does not increase the incidence of MACE.