药物洗脱支架联合氯吡格雷治疗冠心病

Clinical efficacy of drug-eluting stent combined with clopidogrel therapy in patients with coronary heart disease

目的 探讨药物洗脱支架（DES）植入术联合氯吡格雷治疗冠心病患者的临床疗效.方法 123例接受经皮冠状动脉介入治疗（PCI）的患者随机分为观察组（药物洗脱支架治疗）60例和对照组（金属裸支架治疗）63例.观察组采用DES植入＋氯吡格雷维持治疗,对照组采用BMS植入＋氯吡格雷维持治疗.观察支架植入情况,随访2年观察主要心脏事件发生率（MACE）.结果 （1）观察组平均植入支架长度长于对照组（P＜0.05）外,两组在冠状动脉造影血管病变及复杂程度等方面差异无统计学意义（P＞0.05）;两组患者手术成功率均为100%,术后达TIMI血流3级.（2）观察组心绞痛再发生率、再次血运重建率显著低于对照组（P＜0.05）;两组接受冠脉造影复查率、再发心肌梗死和心源性死亡发生率差异无统计学意义（P＞0.05）.结论 DES植入联合氯吡格雷维持治疗1年,远期疗效好.

Objective To investigate the clinical efficacy of drug-eluting stent（ DES） combined with clopi-dogrel therapy in patients with coronary heart disease. Methods 123 patients underwent percutaneous coronary intervention （PCI） were randomly divided into observation group （DES） of 60 cases and the control group （ bare-metal stent,BMS） of 63 cases. The observation group was given the treatment of DES combined clopidogrel, the control group was given the treatment of BMS combined clopidogrel. The stent implantation and the follow-up two-year MACE were observed. Results （1） The average implanted stent length of the observation group was longer than that of the control group（P〈（0.05） ,the angiography in vascular disease and complexity between the two groups had no significant difference （ P 〉 0. 05 ） ; the success rate of surgery in the two groups was 100% , after operation the TIMI flow reached grade 3. （2） The incidence of angina pectoris and revascularization rate of the observation group was significantly lower than that of the control group （P 〈 0.05）; the rate of coronary angiography, recurrent myocardial infarction and the incidence of cardiac death between the two groups had no significant difference （ P 〉 0.05）. Conclusion DES combined with clopidogrel maintenance therapy for a year in patients with coronary heart disease had a good long-term efficacy.