冠状动脉小血管支架植入的临床研究

Clinical application of small vessel stent in small coronary arteries

目的:观察冠状动脉小血管病变患者的临床特点、支架植入情况及预后效果。方法:回顾分析冠状动脉小血管严重狭窄患者的临床及支架植入资料,并与同期进行的冠脉大血管支架患者进行比较,比较二者的临床特点、手术方法及预后的异同。结果:冠脉小血管支架组植入成功率97.14%,大血管支架组植入成功率98.95%(P>0.05);两组在年龄、性别及高血压患病率方面组间比较差异无统计学意义(P>0.05),2型糖尿病患病率在小血管支架组高于大血管支架组(P<0.05);植入方法上,使用球囊预扩的比例两组比较差异无统计学意义(P>0.05);支架释放后球囊后扩张比例小血管支架组低于大血管支架组(P<0.05);术中并发症及随访期预后差异无统计学意义(P>0.05)。结论:冠状动脉小血管支架植入的成功率、预后与大血管支架组无显著差异,可安全地用于冠脉小血管病变的治疗。

Objective： To investigate the characteristics of patients with small coronary artery disease, the rate of success of the procedure, outcome of immediate and follow-up period after the procedure, the incidence of main adverse cardiac events （MACE） after small vessel stent placement in small coronary vessels （reference vessel diameter〈 3.0mm）. Methods： Analyze the data of patients with small vessel stent implantation in our hospital from August 2005 to August 2007. Immediate success rate of procedure and MACE after stent placement were observed during the follow-up time. Results： A total of 182 patients were assigned to either the small vessel stem group or big vessel stem group in term of their reference vessel diameter, 50 patients treated with small vessel stent implantation m 70 small vessels, and 132 patients treated with big vessel stent implantation in 190 big vessels. The success rate of small vessel stent group and big vessel stent group Was 97.14%, 98.95% （P〉0.05）. In age, sex and the rate of hypertensive disease, there were not significant differences between the two groups （P〉0.05）, however, the rate of diabetes was higher in the small vessel stent group than that of the big vessel stent group （P〈0.05）. The rate of post-dilation in the small vessel stent group was lower than that of the big vessel stent-group （P〈0. 05）. The outcome was similar between the two groups in the follow-up （P〉0.05）. Conclusion： The rate of success of the procedure and outcome of small vessel stent placement is similar to big vessel stent group, may be application safely.