【作者】 于海初； 王其新； 赵德民； 邢珂； 中方； 郭明磊；

【Author】 YU Hai-chu,WANG Qi-Xin,ZHAO De-Min,XING Ke,SHEN Fang,GUO Ming-lei. Department of Emergency,the Affiliated Hospital of Medical College Qingdao University,Qingdao(266003),Shandong,China

【机构】 青岛大学医学院附属医院急诊医学中心； 青岛海慈医疗集团急诊医学中心；

【摘要】 目的对比分析急性ST段抬高型心肌梗死(STEMI)患者应用雷帕霉素药物洗脱支架PARTNER和金属裸支架(BMS)的安全性和有效性。方法将2006年1月～2007年3月本中心109例急性STEMI行急诊经皮冠状动脉介入治疗(PCI)的患者,依所置入支架不同,分为药物洗脱支架组64例,BMS组45例。本研究一级终点是9个月的靶病变晚期管腔丢失,次要终点包括9个月的支架内血栓形成和1～2年主要心脏不良事件。结果9个月定量冠状动脉造影分析结果,药物支架组节段内及支架内晚期管腔丢失均小于BMS组(0.31±0.17mm vs 0.71±0.57 mm;0.32±0.18mm vs 0.72±0.56 mm),差异有显著性意义(P<0.01)。BMS组再狭窄率(37. 2%)、靶血管重建(26.3%)显著高于药物支架组(5.8%和4.11%)(P<0.01)。两组患者进行了长期(1～2年)的临床随访,药物支架组和BMS组主要不良事件发生率分别为7.8%和28.8%,差异有显著性意义(P<0.05)。结论急性STEMI患者行急诊PCI时应用雷帕霉素药物洗脱支架PARTNER比用金属裸支架可降低术后9个月的支架内再狭窄率、1～2年的靶血管重建和主要心脏不良事件。更多还原

【Abstract】 Objective To contrast research the safety and efficacy between drug-eluting stent(DES) and bare metal stent(BMS) in acute ST-segment elevation myocardial infarction(STEMI).Methodsl09 patients with STEMI during 2 years were randomized to implantation of DES group(64 cases) and BMS group(45 cases).The primary endpoint of the present study was in lesion late lumen loss(LLL) at 9 months,and secondary endpoint included stent thrombosis and major adverse cardiac events(MACE) at 12 to 24 months. Results Nine-month angiographic follow-up was available in 54.68%and 51.11%of patients assigned to DES and BMS groups,respectively.The mean LLL were 0.32±0.18 mm in the DES group versus 0.72±0.56 mm in the BMS group(P<0.001).At 24-month follow-up,target vessel revascularization and MACE were lower in DES groups than in BMS groups(4.11%vs 26.3%,P<0.05; 7.8%vs 28.8%,P<0.05).Sub-acute thrombosis occurred in 1 patient in each group.Conclusions Implantation of drug-eluting stent for STEMI dramatically reduced restenosis rates at nine-month angiographic follow-up, target vessel revascularization and MACE at 12 to 24 months follow-up compared with BMS.更多还原