不同药物洗脱支架在糖尿病患者中应用的比较

被引：1

作者：

拜文廉 ^{[1
]}

陈康寅 ^{[2
]}

Rha SeungWoon ^{[3
]}

王林 ^{[4
]}

李永健 ^{[5
]}

李广平 ^{[2
]}

机构：

[1] 临夏州人民医院心内科

[2] 天津医科大学第二医院心脏科

[3] 韩国高丽大学附属九老医院心血管病中心

[4] 天津胸科医院心内科

[5] 天津南开医院心内科

来源：

临床荟萃 | 2012年 / 27卷 / 17期

关键词：

糖尿病; 冠状血管造影术; 危险因素; 药物洗脱支架;

D O I：

暂无

中图分类号：

R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）]; R587.1 [糖尿病];

学科分类号：

摘要：

目的对比雷帕霉素、紫杉醇两种不同药物洗脱支架(DES)在糖尿病患者中应用的长期安全性和有效性。方法入选成功行经皮冠状动脉介入治疗(PCI)术的272例糖尿病患者,根据植入支架类型分为雷帕霉素洗脱支架组(sirolimus-eluting stent,SES,n=133例,189病变),紫杉醇洗脱支架组(paclitaxel-eluting stent,PES,n=139例,288处病变),对比随访6个月时的冠状动脉造影结果和随访2年时的主要不良心血管事件(major adverse cardiacevents,MACE)的发生率。结果随访6个月时,复查冠状动脉造影发现,SES组最小管腔直径(2.59±0.61)mm vs(2.21±0.92)mm(P<0.01)显著大于PES组,支架内再狭窄率(16.57±14.24)%vs(30.75±24.16)%(P<0.01)和晚期管腔丢失(0.48±0.51)mm vs(0.93±0.72)mm,P<0.05)显著低于PES组;随访2年时,SES组的总死亡(11.3%vs 20.1%,P<0.05)、靶病变重建(target lesion revascularization,TLR)(9.8%vs 21.6%,P<0.01)、靶血管重建(target vessel revascularization,TVR)(17.3%vs 32.4%,P<0.01)、TVR-MACE(20.3%vs 35.3%,P<0.01)也显著低于PES组。多因素回归分析显示:应用PES是糖尿病患者PCI术后总死亡(OR=2.453,95%CI=1.012～5.932,P<0.05]、TLR(OR=2.403,95%CI=1.051～5.503,P<0.05)、TVR-MACE(OR=2.296,95%CI=1.237～4.261,P<0.01)发生的独立危险因素。结论在临床上对于糖尿病患者PCI术中选择SES相较于PES,可显著降低PCI术后不良心血管事件的发生。

引用

页码：1492 / 1494+1497 +1497

页数：4

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