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目的观察冠状动脉雷帕霉素洗脱支架置入对直径小于2.5mm分支血管的影响。方法选取2002年5月至2004年5月在上海交通大学医学院附属瑞金医院行CypherTM药物洗脱支架和BXVelocityTM普通金属支架置入术的648例患者为研究对象,记录患者冠心病危险因子和冠状动脉病变特征,对比分析两种支架置入对直径小于2.5mm分支血管的影响,并观察患者手术前后血清C反应蛋白和肌钙蛋白变化。结果与普通金属支架组比较,药物洗脱支架组置入支架较长,但两组支架置入后分支闭塞发生率相似。进一步分析支架置入血管狭窄≥90%、分支血管开口处≥50%狭窄538支闭塞高危分支血管,发现药物洗脱支架组(n=259)较普通金属支架组(n=279)支架置入后分支闭塞发生率高(18.5%对16.12%),但差异无显著性意义。结论冠状动脉病变药物洗脱支架置入导致直径小于2.5mm分支血管闭塞发生率与普通金属支架置入相似。
Objective To observe the effect of coronary artery rapamycin eluting stents on branch vessels less than 2.5 mm in diameter. Methods From May 2002 to May 2004, 648 patients with CypherTM drug-eluting stents and BXVelocityTM general metal stents in Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine were enrolled in this study. The risk factors of coronary heart disease Arterial disease characteristics of comparative analysis of two stents on the diameter of less than 2.5mm branch of blood vessels, and observe the changes of serum C-reactive protein and troponin in patients before and after surgery. Results Compared with the common metal stent group, the drug-eluting stent group had a longer stent placement, but the incidence of branch occlusion was similar between the two stent groups. Further analysis showed that the stents were inserted into the blood vessel stenosis≥90%, the diameter of branch vessels ≥50% stenosis 538 branches high-risk branch vessels, and the drug-eluting stent group (n = 259) was found to be inserted into the metal stent group (n = 279) The incidence of posterior branch occlusion was high (18.5% vs. 16.12%), but the difference was not statistically significant. Conclusion The incidence of branch occlusion of coronary artery lesion with drug-eluting stent less than 2.5mm in diameter is similar to that of common metal stent.