两种类型西罗莫司洗脱支架对行PCI治疗的冠心病患者MACE、支架内血栓形成及心脏超声指标的影响

Influence of two kinds of sirolimus eluting stent on MACE,stent thrombosis and echocardiographic indexes in patients with coronary heart disease after PCI

目的探讨涂层不可降解和可降解西罗莫司洗脱支架对行经皮冠状动脉介入(percutaneous coronaryintervention,PCI)治疗的冠状动脉粥样硬化性心脏病(冠心病)患者主要不良心血管事件(major adverse cardiovas-cular event,MACE)、支架内血栓形成及心脏超声指标的影响。方法选取铜川矿务局中心医院2014年4月至2016年4月收治行PCI治疗的冠心病患者共200例,以随机数字表法分为A组(100例)和B组(100例),分别采用涂层不可降解和可降解西罗莫司洗脱支架置入。比较两组随访期间MACE发生率、支架内血栓形成情况及超声心动图指标等。结果两组随访期间MACE发生率比较,差异无统计学意义(P>0.05);两组患者支架内血栓形成情况比较,差异无统计学意义(P>0.05);B组患者术后1年射血分数显著高于术后7 d并显著高于A组,差异有统计学意义(P<0.05);B组术后1年室间隔厚度、左心房内径及左心室舒张末内径均显著优于A组,差异有统计学意义(P<0.05)。结论涂层不可降解和可降解西罗莫司洗脱支架对行PCI治疗冠心病患者总体疗效较为接近;但应用可降解西罗莫司洗脱支架可改善患者远期心脏功能,延缓病情进展。

Objectives To investigate the influence of domestic biodegradable polymer sirolimus-eluting stents and durable polymer sirolimus-eluting stents on major adverse cardiovascular event(MACE),stent thrombosis and echocardiographic indexes in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods Totally 200 patients with coronary heart disease treated by PCI from April 2014 to Apil 2016 in Central Hospital of Tongchuan Mining Bureau were chosen as research objects and randomly divided 2 groups:A group(100 patients)with durable polymer sirolimus-eluting stents and B group(100 patients)with domestic biodegradable polymer sirolimus-eluting stents.Incidence of MACE during follow-up,stent thrombosis occurrence and echocardiographic indexes between the two groups were compared.Results There was no significant difference in incidence of MACE between the 2 groups(P>0.05).There was no significant difference in stent thrombosis occurrence between the 2 groups(P>0.05).Ejection fraction(EF)in 1 year after PCI of B group were significantly better than that in 7 d after PCI and that of A group and(P<0.05).Interventricular septal thickness,left atrium diameter and left ventricular end-diastolic diameter in 1 year after PCI of B group were significantly better than those of A group(P<0.05).Conclusions Domestic biodegradable polymer sirolimus-eluting stents and durable polymer sirolimus-eluting stents in the treatment of patients with coronary heart disease by PCI possess the same clinical effects;but domestic biodegradable polymer sirolimus-eluting stents can effectively improve long-term cardiac function and delay the disease progression.