冠状动脉分叉病变单支架术及双支架术临床疗效对比

目的探讨分叉病变单支架术和双支架术的临床疗效。方法分析冠状动脉分叉病变102例的临床资料，其中52例行单支架术（单支架植入组）、50例行双支架术（双支架植入组）。单支架植入组仅主支植人支架，边支不植入支架；双支架植入组运用mini-crushing技术行双支架植入术。观察两组分叉病变的手术即刻及术后6个月临床疗效及主要心血管事件的发生情况。结果术后即刻冠状动脉造影结果显示两组主支血管心肌梗死溶栓试验（thrombolysisinmyocardialinfarction．TIMI）血流3级、分支血管TIMI血流3级、主支血管残余狭窄〉30％、分支血管残余狭窄〉50％四个指标比较，均差异无统计学意义（P〉0．05）。随访6个月后对两组进行冠状动脉造影后发现，分支血管残余狭窄〉50％在单支架植入组发生率高于双支架植入组，差异有统计学意义25．0％（13／52）vs．12．0％（6／50），P〈0．05]；其余几项两组比较，差异无统计学意义（P〉0．05）。住院期间单支架植入组1例（1．92％）发生主要心血管事件，双支架植入组2例（4．00％）发生主要心血管事件。6个月后．单支架植入组8例（15．38％）发生主要心血管事件，双支架植入组7例（14．00％）发生主要心血管事件。结论单支架术与双支架术治疗分叉病变短期观察临床疗效基本无差异，其长期疗效还需进一步研究。

Comparison in treatments of coronary bifurcation lesions by single stent and double stents

Objectives To study the effects of treatments of coronary bifurcation lesions by single stent and double stents. Methods Clinical data of 102 patients with coronary artery bifurcation lesions were analyzed. Among them, 52 patients received single stent implantation, 50 patients received routine double-stents. In single stent group, stents were implanted only in main branches, not in side branches, while stents were implanted in both main and side branches by mini-crushing approach in double stents group. Clinical effects and major adverse cardiovascular events （MACE） were observed immediately and 6 months after surgery. Results Coronary arteriography immediately after surgery indicated the four indexes thrombolysis in myocardial infarction （TIMI） grade 3 flow in main vessel, TIMI grade 3 flow in branch vessel, residual stenosis 〉 30% at main vessel, residual stenosis 〉 50% at branch vessel] showed no significant differences between the two groups（P〉0.05）. After 6 months＇ follow-up, coronary arteriography showed that incidence rate of residual stenosis 〉 50% at branch vessel was significantly higher in single stent group 25.0% （13/52） vs. 12.0% （6/50）, P〈0.05 ], and there were no significant differences in the other indexes between the two groups （P〉 0.05）. During hospitalization, MACE occurred in 1 patient （1.92%） in single stent group, and 2 （4.00%） in double stents groups. After 6 months＇ follow-up, MACE occurred in 8 patients （15.38%） in single stent group and 7 （14.00%） in double stents groups. Conclusions The short-term clinical efficacy of treatments of bifurcation lesions by single and double stents was similar, and the long-term efficacy still requires further study.