光学相干断层显像观察强化他汀治疗对支架内新生内膜的影响

Effect of intensive statins to in-stent neointima from optical coherence tomography observations

目的:通过光学相干断层显像(OCT)分析强化他汀治疗对支架内膜增生的的影响。方法:入选2014-01-2016-02在我院心内科行冠脉造影+经皮冠状动脉支架植入术(PCI)治疗并予术后1年后行OCT复查的患者44例分为2组:强化剂量他汀治疗组(强化组,阿托伐他汀40mg/d或瑞舒伐他汀20mg/d),常规剂量他汀治疗组(常规组,阿托伐他汀20mg/d、10mg/d或瑞舒伐他汀10mg/d、5mg/d);比较2组之间的临床基线水平、PCI术中参数及复查OCT指标的差异;结果:2组患者的临床基线资料、PCI术中各项参数指标类似,OCT结果发现强化组支架内膜增生厚度较常规组更薄[(212.86±85.16)μm∶(355.65±155.62)μm,P<0.05],同质性比例更高(81.0%∶47.8%,P<0.05)。结论:强化他汀治疗能够抑制支架内膜增生,且发生同质性比例相对更高,可能对稳定内膜及降低支架内再狭窄更具有优势。

Objective：Neointimal hyperplasia is the leading cause of in-stent restenosis.OCT is a superior intravascular imaging modality with a higher resolution to discriminate morphological features of neointima（homogeneous and heterogeneous optical properties）.The aim of this study is to assess the effect of intensive statins to instent neointimal hyperplasia from OCT obversations.Method：The study population consisted of 44 patients with 44drug-eluting stent-treated lesions.Patients received a follow-up OCT examination without any other intervention after about 12 months of statins using.They were divided into two groups：first group：intensive dose group（21patients,atorvastatin 40mg/d or rosuvastatin 20mg/d）and second group：conventional dose group（23patients,atorvastatin 20mg/d,10 mg/d or rosuvastatin 10 mg/d,5 mg/d）,then compared the difference of the two groups.Result：There were no differences of clinical characteristics and parameters during PCI procedural between the two groups.OCT imagings indicated that in-stent neointima was thinner[（212.86±85.16）μm vs（355.65±155.62）μm,P〈0.05]and homogeneity occupied higher proportion in the first group compared with second group（81.0% vs 47.8%,P〈0.05）.Conclusion：Intensive dose statins could depress in-stent neointimal hyperplasia and may induce higher proportion of homogeneous property,it may stabilize neointima and reduce the incidence of instent restenosis.