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目的观察国产西罗莫司药物支架的临床和造影随访效果。方法选择北京安贞医院心内科自2006年8月至2007年10月516例应用国产西罗莫司药物支架的患者,于置入支架9个月(±2个月)后进行电话或门诊随访主要心血管事件(MACE,包括心源性死亡、非致死性心肌梗死、靶血管血运重建)的发生率,尽量进行冠状动脉造影随访,观察患者MACE事件总发生率;同时观察糖尿病亚组的治疗效果;初步评价各种类型病变,包括左主干病变、分叉病变、慢性闭塞病变、钙化病变、开口病变、小血管病变、急性闭塞病变、再狭窄病变的治疗效果;评价药物支架对于以上各类病变的疗效。结果516例患者共置入国产西罗莫司药物支架872枚,成功率为99.5%,其中随访到482例,随访率93.4%。随访到的患者中有18例患者发生MACE事件,发生率为3.5%。造影随访共239例患者,占总例数的46.3%,再狭窄率为11.3%。糖尿病亚组再狭窄率为14%。并对左主干病变、分叉病变、弥漫病变、慢性闭塞病变、小血管病变、钙化病变、急性闭塞病变、开口病变、再狭窄病变分别进行了描述。结论大样本研究显示应用国产西罗莫司药物支架可以取得比较好的疗效。糖尿病亚组患者应用国产药物支架效果良好。初步判断国产药物支架对于弥漫、开口、小血管、再狭窄病变有较好的疗效;对于左主干病变、分叉病变的疗效提示有益的结果,需要继续总结观察。
Objective To observe the clinical and angiographic follow-up effects of domestic sirolimus drug stents. Methods A total of 516 patients with domestic sirolimus medication from August 2006 to October 2007 in Beijing Anzhen Hospital were enrolled. Patients were followed up for 9 months (± 2 months) after stenting The incidence of major cardiovascular events (MACE, including cardiogenic death, non-fatal myocardial infarction, target vessel revascularization), follow-up of coronary angiography as much as possible to observe the incidence of MACE events; at the same time, the diabetic subgroup Treatment effect; preliminary evaluation of various types of lesions, including the left main trunk lesions, bifurcation lesions, chronic occlusive disease, calcified lesions, open lesions, small vessel lesions, acute occlusive lesions, restenosis lesions treatment effect; The efficacy of lesions. Results A total of 872 sirolimus-eluting stents were placed in 516 patients, with a success rate of 99.5%. Among them, 482 patients were followed up, with a follow-up rate of 93.4%. In 18 of the patients who were followed up, MACE occurred at a rate of 3.5%. A total of 239 patients with angiographic follow-up, accounting for 46.3% of the total number of cases, the restenosis rate was 11.3%. Diabetic subgroup restenosis rate was 14%. Left main trunk lesions, bifurcation lesions, diffuse lesions, chronic occlusive lesions, small vessel lesions, calcified lesions, acute occlusive lesions, open lesions, and restenosis lesions were described. Conclusion The large sample study shows that the application of domestic sirolimus drug stent can achieve better therapeutic effect. Diabetic patients with domestic drug stent effect is good. Preliminary judgment of the domestic drug scaffold for diffuse, open, small vessels, restenosis lesions have a good effect; for the left main trunk lesions, bifurcation lesions prompted beneficial results, the need to continue to summarize the observation.