国产BuMA支架在冠心病大小血管病变经皮冠状动脉介入治疗中的疗效比较

目的 评价国产BuMA生物降解药物涂层冠状动脉支架在冠心病小血管病变经皮冠状动脉介入治疗中的临床疗效及安全性.方法 选择182例行经皮冠状动脉介入治疗（PCI）的冠心病患者,其中小血管病变组102例,大血管病变组80例,均置入BuMA生物降解药物涂层冠状动脉支架,比较观察手术成功率、术中并发症及在1～12个月随访期间的心绞痛、猝死、主要不良心脏事件（MACE）发生率及复查冠状动脉造影情况.结果 大血管病变组和小血管病变组手术即刻成功率均为100％,两组共发现203处靶病变,共置入支架273枚.术中均无严重并发症发生.对入选182例患者进行出院后第1、3、6、12个月门诊随访发现,小血管病变组8例心绞痛复发,其中1例为糖尿病患者.大血管病变组5例复发心绞痛.于术后第6～9个月复查冠状动脉造影证实,小血管病变组2例分别为右冠状动脉主干、左前降支支架内远段再狭窄达75％～80％,大血管病变组1例为左前降支支架近端再狭窄75％.两组心绞痛复发、冠状动脉造影支架内再狭窄及靶病变血运重建主要MACE发生率的差异均无统计学意义.两组均未出现迟发性支架内血栓、无心肌梗死及猝死.结论 国产BuMA生物降解药物涂层冠状动脉支架应用于冠心病小血管病变介入治疗安全、有效,疗效不逊于用于冠心病大血管病变时.

Comparison of therapeutic effects of biodegradable drug-eluting stent between big and small coronary artery lesions in patients receiving interventional therapy

Objective To evaluate the safety drug coating coronary stentt on big vessel diameter ≥ 3 and clinical effects of domestic BuMA biodegradable 0 mm and small vessel lesions in patients with coronary artery disease receiving intervcntional therapy. Methods 182 patients of coronary heart diseases undergoing percutaneous coronary intervention （PCI） with BuMA biodegradable drug coating coronary stent includingl02 patients with small coronary artery lesions and 80 ones with big vessel lesions.The success rate of PCI, intraoperative complications and the occurrence of angina, sudden death as well as results of coronary angiography during follow-up period from 1 to 12 months were observed and comparatively analyzed. Results The instant success rate of PCI in both groups was 100%. There were 203 stents implanted into 273 lesions and no severe complications occurred during the procedure. In the small vessel group, eight patients had recurent angina including one diabetic patient. In the big vessel group, angina occurred in five patients.There was no delayed intemal stent thrombosis, myocardial infarction or sudden death in both groups. Conclusions This novo-domestic BuMA biodegradable drug coating coronary stent is safe and effective for interventional therapy of small artery coronary lesions and it demonstrates similar curative effects on small and big vessel lesions treated by PCI.