雷帕霉素药物洗脱支架的早中期安全性及有效性评价

目的评价雷帕霉素药物洗脱支架（drug—elutingstent，DES）在冠脉病变介入治疗后的安全性与有效性。方法从2009年1月1日-2011年11月1日期间在我院心血管内科行冠状动脉造影并置入雷帕霉素药物洗脱支架的患者中随机筛选500例，按随访时间将其分为术后1年随访组（130例）、术后3年随访组（139例）2组。采用电话随访或门诊检查，必要时复查冠脉造影观察在支架置入后不良心血管事件发生情况及靶血管复查造影情况。结果两组不良心血管事件总体发生率有统计学差异（3．25％VS13．28％，P=0．04），其中靶病变血运重建发生率（2．44％VS8．59％，P=0．03）有统计学意义，而心源性死亡发生率f0．81％vs2．34％，P=0．64）和非致死性心肌梗死发生率（0．00％阳2．34％，P=0．26）无统计学差异；两组造影复查支架再狭窄率（4．88％瑚14．84％，P=0．008）有统计学意义。结论支架置入术术后3年与术后1年相比有较高的靶血管血运重建率及支架再狭窄率。

Early and intermediate safety and efficiency of rapamycin-eluting stent

Objective To study the safety and efficiency of rapamycin-eluting stent in coronary heart disease （CHD） patients after intervention therapy. Methods Two hundred and sixty-nine CHD patients who underwent coronary arteriography and rapamycin-eluting stent implantation in our department from January 1, 2009 to November 1, 2011 were randomly divided into 1-year follow-up group （n=130） and 3-year follow-up group （n=139）. Their major adverse cardiovascular events （MACE） and target vessel revascularization （TVR） after rapamycin-eluting stent implantation were observed by coronary arteriography. Results The total incidence of MACE and TVR was significantly lower in 1-year follow-up group than in 3-year follow-up group （3.25% vs 13.28%, P=0.04; 2.44% vs 8.59%, P=0.03） while no significant difference was observed in the incidence of cardiac death and non-fatal myocardial infarction between the two groups （0.81% vs 2.34% and 0.00% vs 2.34%, P=0.64, P=0.26）. Coronary arteriography showed that the incidence of restenosis was significantly lower in 1-year follow-up group than in 3-year follow-up group （9.4% vs 20%, P=0.02）. Conclusion The incidence of TVR and restenosis is higher in 3-year follow-up group than in 1-year follow-up group after rapamycin-elutin stent imolantation.