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目的:比较采用紫杉醇药物洗脱支架(PES)和金属裸支架(BMS)治疗弥漫长病变的近期和远期预后。方法:患者为我院接受置入单个长度>25 mm紫杉醇药物洗脱支架(PES组,n=68)或金属裸支架(BMS组,n= 132)治疗并且进行冠状动脉造影随访的200例患者。患者在支架术后6个月后接受冠状动脉造影随访。结果:在患者临床基本条件方面PES组较BMS组2型糖尿病患者更多,有显著性差异;在病变基本条件方面,PEs组术前参考血管直径明显小于BMS组,支架长度大于BMS组。6个月后的随访结果显示支架内再狭窄率PES组小于BMS组(P=0．002)。晚期腔径丢失BMS组明显大于PES组(P<0．001)。靶病变血管重建率(TLR)PES组有好于BMS组[10(13．5％)vs．35(24．3％),P=0．062]的趋势,但是没有达到统计学差异。结论:本研究发现对于弥漫长病变的治疗,PES较BMS明显减少晚期腔径丢失和支架再狭窄率,靶病变血管重建率两组并没有差异,临床效果尚需进一步观察。
OBJECTIVE: To compare the short-term and long-term prognosis of diffuse lesions with paclitaxel-eluting stent (PES) and bare metal stent (BMS). METHODS: Totally 200 patients were treated in our hospital for single-length> 25 mm paclitaxel-eluting stents (PES group, n = 68) or bare-metal stents (BMS group, n = 132) and were followed up by coronary angiography . Patients were followed up for coronary angiography 6 months after stenting. Results: There were more significant differences in clinical basic conditions between PES group and BMS group. The preoperative baseline diameter of PEs group was significantly smaller than that of BMS group and the length of stent was larger than that of BMS group. Follow-up after 6 months showed that the rate of in-stent restenosis was lower in the PES group than in the BMS group (P = 0.002). Late luminal loss in the BMS group was significantly greater than in the PES group (P <0.001). Target lesion revascularization (TLR) PES group was better than BMS group [10 (13.5%) vs. 35 (24.3%), P = 0.062], but did not reach statistical significance. CONCLUSIONS: In this study, we found that PES has a significant reduction in late luminal loss and stent restenosis compared with BMS, and there is no difference between the two groups in the target vessel revascularization rate. The clinical effect needs to be further observed.