杜润,张瑞岩,朱政斌,张奇,胡健,张建盛,沈卫峰

• 1:上海交通大学医学院附属瑞金医院心脏科

摘要(Abstract)：

目的利用血管内超声(IVUS)方法比较国产西罗莫司洗脱支架(FirebirdTM)与紫杉醇洗脱支架(TaxusTM)对冠心病患者新生内膜增生的抑制作用。方法自2003年5月至2007年6月,203例冠心病患者(283处病变)行药物洗脱支架术并在术后1年行冠状动脉造影和血管内超声(IVUS)检查。其中136例患者(185处病变)置入FirebirdTM支架(Firebird组),67例患者(98处病变)置入TaxusTM支架(Taxus组)。结果203例患者(283处病变)中168例患者(236处病变)接受了一年随访造影和血管内超声检查,其中Firebird组108例患者(147处病变),Taxus组60例患者(89处病变)。两组患者基础临床情况及造影特征相似。Firebird组支架内晚期管腔丢失(0.17±0.29mm比0.43±0.51mm,P<0.0001)和节段内晚期管腔丢失(0.18±0.36mm比0.38±0.33mm,P=0.003)明显小于Taxus组,而两组近端参考血管晚期管腔丢失(0.11±0.27mm比0.15±0.32mm,P=0.321)和远端参考血管晚期管腔丢失(0.08±0.10mm比0.09±0.16mm,P=0.483)差异并无统计学意义。IVUS分析显示,两组间平均支架面积、平均管腔面积、最小支架面积、平均支架体积、平均管腔体积比较,差异均无统计学意义。但Firebird组平均内膜增生面积(0.35±0.58mm2比1.29±1.26mm2,P<0.0001)、平均内膜增生面积百分数(5.45%±9.26%比17.38%±13.75%,P<0.0001)、内膜增生最大面积百分数(9.41%±14.15%比31.56%±20.99%,P<0.0001)、平均内膜增生容积(2.09±5.46mm3比13.43±18.59mm3,P<0.0001)和平均内膜增生容积百分数(1.68%±5.84%比8.62%±9.90%,P<0.0001)较Taxus组均明显减少。结论国产西罗莫司洗脱支架(FirebirdTM)置入术后再狭窄发生率较低,与TaxusTM支架相比,抑制内膜增生作用更显著。

关键词(KeyWords)： 支架;血管内膜;超声检查,介入性;西罗莫司;紫杉醇

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 杜润,张瑞岩,朱政斌,张奇,胡健,张建盛,沈卫峰

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