摘要
目的探讨雷帕霉素洗脱支架在高龄冠心病患者中应用的安全性和有效性。方法2003年3月至2006年2月间共80例冠心病患者接受雷帕霉素洗脱支架治疗(包括进口Cypher支架和国产Firebird支架),按年龄分为高龄组(≥70岁)51例,对照组(<60岁)29例。记录并比较两组基本临床情况、冠状动脉造影与介入治疗情况和术后临床疗效及随访结果。结果两组患者除了年龄外,其他基本临床特征无显著差异;造影结果显示高龄组多支血管病变比例大于对照组;支架手术时高龄组在靶病变严重程度、平均手术血管支数、支架个数、支架总长度均高于对照组,完全血运重建比例低于对照组;两组直接支架术比例分别为7.84%和27.59%(P<0.05),需后扩张修饰分别为43.14%和20.69%(P<0.05);术后18.9±8.5个月临床随访,两组心绞痛复发率分别为25.49%和6.90%(P<0.05),严重心脏不良事件发生率分别为13.73%和6.70%(P>0.05)。结论雷帕霉素洗脱支架在高龄冠心病患者中应用是安全有效的,但术后随访心绞痛复发率较高。
Objective To observe the safety and efficacy of rapamycin eluting stent in elderly patients with coronary heart disease. Methods From March 2003 to Feb 2006, a totle 80 consecutive patients with de nove lesions underwent stenting with Cypher or Firebird stent, including 51 patients aged ≥70 years （group A） and 29 ：ged 〈 60 years （group B）. The baseline clinical characteristics, angiograplfic, PCI （percutaneous coronary intervention） outcomes and clinical follow-up were recorded and compared between two groups. Results Tile baseline clinical characteristics were similar between two groups, except the age in group A is older than that in group B. According to angiographic and PCI outcomes, the multi - vessel lesion in group A was more than in group B. The extent of procedural lesion type, number of procedural vessels and implanted stent per patient in group A were greater than in group B. In group A, the total stent length per patient was longer and the rate of complete revascularization was lower, compared with group B. In group A and group B, the rate of direct - stenting was 7.84% and 27.59%, respectively （P〈0.05） and the rate of high- pressure post- dilatation was 43.14% and 20.69 %, respectively （P 〈 0.05）. During 18.9 ± 8.5 months＇ follow - up, the recurrence rate of chest pain was 25. 49 % and 6.90 % （ p 〈 0.05） and the incidence of major adverse cardiac event （MACE） was 13.73 % and 6.70 % （P 〉 0. 05） in group A and B, respectively. Conclusions Rapamycin eluting stent for elderly patients with coronary heart disease is safe and effective, but may have more recurrence of chest pain during follow - up.
出处
《心脑血管病防治》
2007年第2期86-88,共3页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
基金
温州市卫生局科技计划项目(2004043)
