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目的进口和国产药物洗脱支架(DES)治疗急性ST段抬高心肌梗死(STEMI)的住院期间与远期预后比较。方法连续入选2009年1月至2010年8月的197例确诊急性STEMI并行冠状动脉介入治疗的患者,按照支架的类型分为国产DES组和进口DES组,比较两组住院期间和长期心脑血管事件发生率。结果国产DES组共113例(57.4%),进口DES组84例(42.6%),两组住院期间全因死亡率(2.7%比4.8%,P=0.515)、严重心力衰竭发生率(2.7%比0,P=0.053)、恶性心律失常发生率(10.6%比3.6%,P=0.098)差异均无统计学意义;两组患者随访中位数41个月,随访期内两组的无事件生存率分别为91.5%和90.9%(P=0.885)。多因素分析显示,高龄(HR=1.872,95%CI:1.008~2.118,P=0.023)、高血压史(HR=6.018,95%CI:1.307~21.716,P=0.021)、脑血管病史(HR=4.995,95%CI:1.536~16.242,P=0.008)、心功能Killip分级(HR=3.947,95%CI:1.809~8.612,P=0.001)、高尿酸血症(HR=1.006,95%CI:1.003~1.010,P<0.001)是患者远期发生全因死亡、非致死性心肌梗死、再次血运重建、严重心力衰竭、脑血管病的独立危险因素。结论急性STEMI患者,应用国产与进口DES住院期间及远期预后差异无统计学意义。
Objective To compare the long-term and long-term prognosis of imported and domestic drug-eluting stents (DES) in the treatment of acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 197 consecutive patients with acute STEMI undergoing coronary intervention from January 2009 to August 2010 were selected and divided into domestic DES group and imported DES group according to the type of stent. The duration of hospitalization and long-term cardiovascular and cerebrovascular Incident rate. Results There were 113 cases (57.4%) in DES group and 84 cases (42.6%) in DES group. The incidence of all-cause (2.7% vs 4.8%, P = 0.515), severe heart failure (2.7% (P> 0.05). The incidence of malignant arrhythmia (10.6% vs. 3.6%, P = 0.098) had no statistical significance. The median follow-up time was 41 months in both groups. No events Survival rates were 91.5% and 90.9%, respectively (P = 0.885). Multivariate analysis showed that the incidence of hypertension (HR = 1.872,95% CI: 1.008-2.1180, P = 0.023), history of hypertension (HR = 6.018,95% CI: 1.307-21.716, P = 0.021) (HR = 3.947, 95% CI: 1.809-8.612, P = 0.001), hyperuricemia (HR = 1.006, 95% CI = 4.995, 95% CI: 1.536-16.242, P = 0.008) : 1.003 ~ 1.010, P <0.001) were independent risk factors of long-term all-cause mortality, non-fatal myocardial infarction, revascularization, severe heart failure and cerebrovascular disease. Conclusion There is no significant difference in the duration of hospitalization and long-term prognosis between acute STEMI patients and domestic-made and imported DES patients.