西洛他唑对冠状动脉小血管病变支架术后患者的长期疗效

Long-term effects of cilostazol on clinical outcomes after coronary stent implantation in small-vessel lesions

目的:探讨西洛他唑对冠状动脉小血管病变普通金属支架置入术后再狭窄的防治作用及长期临床疗效的影响.方法:193例接受冠状动脉支架术的患者随机分两组,二联组(阿斯匹林+氯吡格雷)98例,三联组(阿斯匹林+氯吡格雷+西洛他唑)95例.两组均服用阿斯匹林300mg/d,1mo后改为100mg/d长期,以及氯吡格雷75mg/d,3mo;三联组术后加用西洛他唑200mg/d,6mo.患者于术后6mo行冠脉造影随访和1a临床随访.结果:二联组和三联组术后6mo造影再狭窄率分别为33%(17/52)和23%(12/53)(P>0.05).二组术后1a内因心、脑血管事件再住院率分别为26%和16%(P>0.05).两组均无严重出血等副作用,轻微出血亦无明显差异(2%vs5%,P>0.05).结论:两组造影再狭窄率及1a内因心、脑血管事件再住院率无明显差异,出血等副作用无明显差异.支架术后常规抗血小板治疗基础上合用西洛他唑有降低再狭窄率的趋势.

AIM: To evaluate the effects of cilostazol on small-vessel lesions and long-term clinical outcomes in patients receiving coronary stent implantation. METHODS: One hundred and ninety-three patients who had underwent coronary stenting were randomly assigned to two groups after operation. Ninety-eight patients who had been taking aspirin 100 mg/d were given clopidogrel treatment 75 mg/d for 3 months in control group and 95 patients were given clopidogrel treatment 75 mg/d for 3 months plus cilostazol 200 mg/d for 6 months in treatment group. Angiographic follow-up was carried out at 6 months and clinical follow-up at 1 year after stenting. RESULTS: Angiographic restenosis occurred in 12 of the 53 patients (23%) in the treatment group and 17 of 52 patients (33%) in the control group (P> 0.05). By the end of 1 year follow-up after operation, no difference was found in the rates of readmission due to cardiac and cerebral vascular diseases and no difference was found in the side-effects of drugs such as hemorrhage between the two groups. CONCLUSION: Cilostazol treatment after PCI is safe and the treatment with cilostazo can decrease the rate of restenosis.