进口雷帕霉素洗脱支架治疗冠心病合并糖尿病患者的疗效观察

目的]评价进口雷帕霉素洗脱支架（Cypher）在冠心病合并糖尿病患者中的治疗效果。方法]192例冠心病合并糖尿病患者随机分为两组,分别植入雷帕霉素涂层支架及普通支架,普通支架组（Vision）80例,均成功进行经皮冠状动脉介入治疗（PCI）。两组患者术后均正规应用抗凝、抗血小板及调脂治疗。随访6-8个月,观察并记录再狭窄、主要心血管事件（泵衰竭、急性心肌梗死）、心脏性猝死等心脏事件。结果]6~8月中Cypher支架组发生心脏性猝死1例,急性心肌梗死0例,2例泵衰竭;其中70例复查冠状动脉造影发现支架再狭窄5例,占7.14%。普通支架组发生心脏性猝死1例,急性心肌梗死1例,2例泵衰竭;其中53例复查冠状动脉造影发现支架再狭窄7例,占13.2%。Cypher支架组再狭窄率明显少于普通支架组,且不增加主要心血管事件的风险。结论]与普通支架组相比,Cypher支架对糖尿病合并冠心病的患者效果更好。

STUDY ON THE EFFECT OF CYPHERTM STENT IMPLANTATION FOR PATIENTS WITH CORONARY HEART DISEASE COMBINED DIABETES

Objective]To evaluate the clinical therapeutic effect of CYPHERTM stent(rapamycin)implantation for patients with coronary heart disease(CHD)combined diabetes.Methods]192 patients with coronary heart disease combined diabetes were randomly divided into two groups,and were implanted by CYPHERTM stent(112 cases)and ordinary stent(80 cases)respectively,then all were treated with percutaneous coronary intervention(PCI)successfully.Each paitient in this study accepted the regular anticoagulation and degrading blood-fat after operation therapy.All patients were followed up for 6-8 months and the major adverse cardiac events(MACE)were recorded.Results]There were 5 cases of in-stent restenosis(ISR)occurring in 70 cases in CYPHERTM stent group,with the rate of 7.14%,and 7 cases of ISR occured.In 53 cases in ordinary stent group,the rate was 13.2%.One case of sudden cardiac death,one case of acute myocardial infarction(AMI),one case of angina pectoris recurrence occurred in CYPHERTM stent group,and the corresponding data in ordinary stent group were one case,one case and two cases respectively.The restenosis rate of CYPHERTM stent group was obviously lower than that of ordinary stent group,and it didn't increase the risk of major adverse cardiac events.Conclusion]Compared with ordinary stent,the clinical therapeutic effects of CYPHERTM stent(rapamycin)implantation is better for patients with coronary heart disease(CHD)combined diabetes.