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目的比较雷帕霉素洗脱支架(SES)和紫杉醇洗脱支架(PES)对长度≥25mm复杂病变的疗效。方法入选138例患者(男124例,女14例)冠状动脉(冠脉)病变长度≥25mm,接受SES和PES介入治疗,并且在支架术后6个月左右接受冠脉造影随访。结果共147处病变在6个月后随访。其中2型糖尿病患者43例(31·2%),C型病变129处(87·8%)。SES组的支架内再狭窄率(5·9%,17·7%,P=0·023)、支架段再狭窄率(9·4%,21·0%,P=0·048)和支架段晚期腔径丢失[(0·16±0·52)mm比(0·45±0·65)mm,P=0·003)]、支架内晚期腔径丢失[(0·26±0·46)mm比(0·60±0·66)mm,P=0·001)]明显低于PES组。两组之间在随访期间靶病变血管重建率(7·1%比12·9%,P=0·223)差异无统计学意义。结论对于复杂弥漫病变SES在再狭窄率和晚期腔径丢失要优于PES,对于远期预后的影响还需要进一步的观察。SES更适合用于复杂小血管病变。
Objective To compare the efficacy of rapamycin-eluting stent (SES) and paclitaxel-eluting stent (PES) in complex lesions of length ≥25 mm. Methods A total of 138 patients (124 males and 14 females) were enrolled in this study. Coronary (coronary) lesions ≥25 mm in length were treated with interventional therapy of SES and PES and were followed up for coronary angiography at about 6 months after stenting. Results A total of 147 lesions were followed up after 6 months. There were 43 cases (31.2%) of type 2 diabetic patients and 129 (87.8%) cases of type C diabetic patients. The in-stent restenosis rates (5.9%, 17.7%, P = 0.023), stent restenosis rates (9.4%, 21.0%, P = 0.048) and stent The loss of late luminal diameter was (0 · 16 ± 0 · 52) mm (0 · 45 ± 0.65) mm, P = 0.003), and the late stent loss [0 · 26 ± 0 · 46 mm) was significantly lower than that of the PES group (0.60 ± 0.666 mm, P = 0.001). The target vessel revascularization rate (7.1% vs 12.9%, P = 0.223) was not significantly different between the two groups during follow-up. Conclusions SES is superior to PES in the restenosis rate and late lumpectomy loss for complex diffuse lesions, and further study is needed for the long-term prognosis. SES is more suitable for complex small vessel disease.