药物洗脱支架与单纯球囊扩张术在急性心肌梗死小血管罪犯病变中应用的对照研究

Comparison of implantation of drug-eluting stent with balloon angioplasty only in small target vessels of patients with acute myocardial infarction

目的探讨药物洗脱支架在急性心肌梗死小血管罪犯病变介入治疗中的安全性与有效性。方法共入选1 364例罪犯血管为小血管病变(靶血管直径≤2.5 mm)的急性心肌梗死并接受成功PCI治疗患者,根据治疗方案分为药物洗脱支架组(支架组,n=683),单纯球囊扩张组(球囊扩张组,n=681),对比两组患者随访8个月时的主要不良心脏事件的发生情况。结果支架组与球囊扩张组相比,总病死率显著减低(P=0.049),其他不良心脏事件发生率两组间比较无统计学差异。结论急性心肌梗死小血管病变患者即使闭塞血管已再通,置入药物洗脱支架也是必要的。

Objective To compare the safty and efficacy of drug-eluting stent（DES） implantation with balloon angioplasty only in small target vessels of patients with acute myocardial infarction（AMI）.Methods A total of 1 364 AMI patients who received successful percutaneous coronary intervention（PCI） in small target vessels were enrolled.Patients were divided into DES therapy group（stenting group,n=683） and balloon angioplasty only group（ballooning group,n=681）.Various major adverse cardiac events at 8 months were compared.Results Clinical outcomes at 8 months showed that stenting group had a significantly lower incidence of total death than ballooning group（P=0.049）.Conclusion DES implantatin in small target vessels of AMI patients might be necessary even when the antegrade blood flow has been successfully restored.