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目的:应用光学相干断层成像技术观察佐它莫司药物洗脱支架置入后不同时期的新生内膜覆盖和支架贴壁情况以评估血管愈合。方法:对符合标准的30例置入佐它莫司药物洗脱支架患者进行介入后即刻、介入3个月和介入9个月时的光学相干断层成像检查,每隔1 mm评估横断面影像每个支架柱的新生内膜覆盖和贴壁情况,同时观察每个支架内的血栓发生情况。结果:介入3个月和介入9个月时比较,新生内膜增生厚度:(154±77)μm vs(265±130)μm,差异有统计学意义(P<0.05);无新生内膜覆盖支架柱:(0.1±1.1)%vs(0.1±0.4)%,差异无统计学意义(P>0.05);有完全新生内膜覆盖的支架数:27个(87.1%)vs 29个(93.6%),差异无统计学意义(P>0.05)。支架柱贴壁不良发生率:介入后即刻(6.0±6.2)%,至介入3个月和介入9个月时减少为(0.2±1.1)%和(0±0)%,差异有统计学意义(P<0.05);冠状动脉内血栓:介入3个月1个(3.2%)和介入9个月1个(3.2%),显著低于介入后即刻11个(35.3%),差异有统计学意义(P<0.05)。结论:佐它莫司药物洗脱支架介入3个月时,大部分支架即达到了完全新生内膜覆盖且支架柱贴壁不良发生率明显减低,显示了良好的血管愈合反应,但随时间延长,介入9个月时新生内膜继续增生,较前明显增厚。
OBJECTIVE: To evaluate the neovascularization of neointimal hyperplasia and scaffold by using optical coherence tomography at different stages after Zotaxan drug-eluting stent implantation. Methods: Thirty patients who met the criteria for inclusion of drug-eluting stent were examined with optical coherence tomography at 3 months and 9 months after intervention. The cross-sectional images were evaluated every 1 mm New stent neointimal coverage and adherent conditions, while observing the occurrence of thrombosis within each stent. Results: The thickness of neointimal hyperplasia was (154 ± 77) μm vs (265 ± 130) μm, the difference was statistically significant (P <0.05). There was no neointimal hyperplasia The number of scaffolds with complete neointimal coverage was 27 (87.1%) vs 29 (93.6%). The number of scaffolds was (0.1 ± 1.1)% vs (0.1 ± 0.4)% and the difference was not statistically significant ), The difference was not statistically significant (P> 0.05). Incidence of poor adherence to the stent column: (6.0 ± 6.2)% immediately after intervention, to (0.2 ± 1.1)% and (0 ± 0)% at 3 months after intervention and 9 months after intervention, the difference was statistically significant (P <0.05). Thromboembolism in coronary artery was significantly lower than that of 11 patients (35.3%) at 1 month after intervention (3.2%) and at 1 month after intervention Significance (P <0.05). CONCLUSIONS: At 3 months after intervention with zotarolimus-eluting stents, most of the stents reached a complete neointimal coverage with significantly reduced adherence to the stent column, indicating good vascular healing but with prolonged time , 9 months into the neointimal hyperplasia, significantly thicker than the previous.