紫杉醇微孔载药冠状动脉支架治疗老年急性冠脉综合征疗效及安全性的临床研究

Study of Paclitaxel-eluting sent:safety and efficacy of paclitaxel-eluting sent in treatment of acute coronary syndrome of elderly patients

目的通过对比研究的方法评价紫杉醇微孔载药冠状动脉支架在老年急性冠脉综合征患者中应用的安全性和有效性。方法老年急性冠脉综合征患者120例常规冠状动脉造影,进行经皮冠状动脉介入治疗,其中60例植入紫杉醇微孔载药冠状动脉支架(Yinyi支架),60例植入载雷帕霉素可降解聚合物涂层支架(EXCEL支架),术前术后常规使用阿司匹林和氯吡格雷。观察两组住院期间和6个月随访期间的心血管事件及支架内再狭窄的发生情况。结果紫杉醇微孔载药冠状动脉支架组(Yinyi组)和载雷帕霉素可降解聚合物涂层支架组(EXCEL组)两组患者支架置入成功率均为100%,除YINYI组1例患者第4个月非心源性死亡外,其余患者均完成了临床随访,平均随访(6.03±0.17)个月。YINYI组和EXCEL组分别有11例、14例再次行冠脉造影,3例、2例发生了冠状动脉造影证实的支架内再狭窄,均成功施行了靶病变血运重建(Target lesion revas-cularization TLR)。YINYI组和EXCEL组6个月内MACE发生率分别为5.0%与3.3%(P>0.05),无统计学差别。结论紫杉醇微孔载药冠状动脉支架(Yinyi支架)临床应用安全,近期疗效与载雷帕霉素可降解聚合物涂层支架(EXCEL支架)相近,更长期的临床疗效比较尚有待于进一步随访观察。

Objective To evaluate the safety and efficacy of paclitaxel-eluting sent in treatment of acute coro- nary syndrome of elderly patients by the way of contrast. Methods 120 patients were enrolled in the study. All patients received coronary angiogram and percutaneous coronary intervention. 60 patients were implanted with pa- clitaxel-eluting sent（YINYI）and 60 patients were implanted with rapamycin-e＇, ＇,lg coronary stent （ EXCEL ）. Both major adverse cardiac events and restenosis were observed at 6 months follow-up. Results The success rates of two groups were both 100 %. In YINYI group and EXCEL group.the incidences of major adverse cardiac events were 5.0 % and 3.3 % （P~ 0.05） during 6 months. There is no significant difference. Conclusion Paclitaxel-elu- ting sent is safe and effective in clinical application. It could provide similar outcomes as rapamycin-eluting coro- nary stent.