紫杉醇支架冠状动脉造影随访结果分析

Angiographic follow-up study of the effect after Taxus DES implantation in coronary artery disease patients

目的 观察紫杉醇洗脱支架治疗冠心病的临床实际疗效。方法 297例患者接受紫杉醇洗脱支架治疗，均接受了临床随访，134例于支架置入术后5-15个月行冠状动脉造影随访。结果 冠状动脉造影随访时，晚期管腔丢失支架内显著高于支架近端边缘及支架远端边缘（分别为0.37、0.18和0.12mm），再狭窄率为10．4％，以支架内弥漫性狭窄为主，再血管化率为6．7％。1例患者于支架置入后4个月发生猝死，发生率为0．34％。1例于支架置入后5天发生支架内亚急性血栓形成，发生率0．34％。晚期血栓形成2例（术后12-24个月），主要心血管不良事件发生率1．35％。结论 紫杉醇药物洗脱支架对复杂冠脉病变有较好的疗效，能显著降低支架后再狭窄率及靶血管的再血管化率。

Objective To evaluate the angiographic effect in patients treated with Taxus DES implantation in clinical practice. Methods Two hundred and ninty-seven patients were treated with Taxus DES implantation and 134 patients underwent angiographic follow-up from 5 to 15 months. Results Angiographic follow-up the in-stent late loss was higher than pro-in-lesion and dis-in lesion late lumen loss （0. 37 vs O. 18 vs 0. 12mm,P〈0. 05）. There were 14 case of restenosis in stentt （10. 4%） and 7 of 14cases were diffuse restenosis in stents （50%）. Target lesion revascularization was performed in 6 cases （6. 7%）. One patient died suddenly at 5th day after the procedure. The rate of sudden death was 0. 34%. One patient occurred subacute thrombosis in hospital （0. 34%） and two late thrombosis oceured in 12 and 24 months after operation （0. 68%）. The rate of the incidence of major adverse cardiac events was 1.35%. Conclusion Unrestricted utilization of Taxus DES in daily practice is effective in reducing both restennosis and revascularization.