雷帕霉素与紫杉醇洗脱支架置入治疗冠状动脉病变的有效性

Efficacy of rapamycin and paclitaxel eluting stent implantation in treatment of coronary artery disease

背景:药物洗脱支架置入治疗冠状动脉病变具有良好的临床效果,但不同支架的治疗效果可能存在一定差异。目的:比较不同支架置入治疗冠状动脉病变的临床效果。方法:纳入278例冠状动脉病变患者,均接受冠状动脉支架置入治疗,其中91例置入雷帕霉素洗脱支架,92例置入紫杉醇洗脱支架,95例置入裸金属支架。支架置入后随访12个月,记录死亡和心肌梗死等不良心脏事件发生情况,以及冠状动脉再狭窄发生情况及材料宿主反应。结果与结论:雷帕霉素洗脱支架组与紫杉醇洗脱支架组冠状动脉再狭窄率、急性心肌梗死发生率、冠状动脉旁路移植或再次经皮冠状动脉介入治疗率均低于裸金属支架组(P<0.05),雷帕霉素洗脱支架组与紫杉醇洗脱支架组上述指标比较差异均无显著性意义(P>0.05)。3组死亡率比较差异无显著性意义(P>0.05)。3组均未发生支架移位、脱落、断裂、置入位置不良及白细胞增多和血小板减少、溶血等情况。表明两种药物洗脱支架的治疗效果相当,均优于裸金属支架。

BACKGROUND： The clinical effect of drug-eluting stent implantation in treatment of coronary artery disease is good, but there may be some differences in the therapeutic effect between different stents. OBJECTIVE： To compare the clinical effect of different stent implantation in treatment of coronary artery disease. METHODS： A total of 278 patients with coronary artery disease were enrolled and all underwent coronary artery stent implantation treatment, of which 91 patients underwent implanted rapamycin eluting stent, 92 patients underwent implanted paclitaxel eluting stent, and 95 patients underwent implanted bare metal stents. All the patients were followed up for 12 months after stents implantation. The occurrence of adverse cardiac events such as death, myocardial infarction, and the occurrence of coronary restenosis and host reaction were recorded. RESULTS AND CONCLUSION： The rates of coronary artery stenosis, acute myocardial infarction, coronary artery bypass grafting or second-time percutaneous coronary interventional therapy in the paclitaxel eluting stent and rapamycin eluting stent groups were all lower than those in the bare metal stent group（P〈0.05）. There were no significant differences in the above indicators between paclitaxel eluting stent and rapamycin eluting stent groups（P〈0.05）. There was no significant difference in the mortality between these three groups（P〈0.05）. There was no stent shift, shedding, breakage, bad implantation position, leukocytosis, thrombocytopenia and hemolysis in these three groups. These results demonstrate that the therapeutic effects of these two kinds of drug-eluting stents are all good enough, and better than those of bare metal stents.