涂层可降解与不可降解西罗莫司洗脱支架在经皮冠状动脉介入治疗中的疗效和安全性Efficacy and safety of domestic biodegradable polymer sirolimus-eluting stents and durable polymer sirolimus-eluting stents in the treatment of coronary artery disease
方毅,王斌,李晶,裘淼涵,韩雅玲
摘要(Abstract):
目的比较国产涂层可降解与涂层不可降解西罗莫司(雷帕霉素)洗脱支架(sirolimuseluting stents,SES)在冠心病患者行经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)中的有效性和安全性。方法选取2012年10月至2014年1月在沈阳军区总医院置入SES的冠心病患者2950例,其中涂层可降解SES组患者1520例,涂层不可降解SES组患者1430例。采用倾向评分配对分析对基线不匹配患者行1∶1匹配后得到倾向匹配队列,观察两组患者PCI术后主要不良心血管事件(major adverse clinical events,MACE,包括心源性死亡、非致死性心肌梗死、靶血管血运重建)和支架内血栓的发生率。结果随访1年,涂层可降解SES组和涂层不可降解SES组的MACE[85例(6.8%)比75例(6.0%),P=0.414]、心源性死亡[20例(1.6%)比18例(1.4%),P=0.744]、非致死性心肌梗死[28例(2.2%)比22例(1.8%),P=0.391]、靶血管血运重建[44例(3.5%)比36例(2.9%),P=0.363]、支架内血栓[14例(1.1%)比8例(0.6%),P=0.284]的发生率分别比较,差异均无统计学意义。结论国产涂层可降解与不可降解SES在冠状动脉疾病治疗中的近期疗效和安全性相似,其远期效果有待进一步研究。
关键词(KeyWords): 药物洗脱支架;涂层可降解;涂层不可降解;西罗莫司
基金项目(Foundation): 军队临床高新技术重大项目(2010gxjs001);; 辽宁省科技攻关项目(2013225089)
作者(Author): 方毅,王斌,李晶,裘淼涵,韩雅玲
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