中国循环杂志
中國循環雜誌
중국순배잡지
CHINESE CIRCULATION JOURNAL
2014年
9期
670-673
,共4页
李晓涛%王乐丰%杨新春%王红石%孙浩%高京宏%夏昆%薛永利%薛静%徐超
李曉濤%王樂豐%楊新春%王紅石%孫浩%高京宏%夏昆%薛永利%薛靜%徐超
리효도%왕악봉%양신춘%왕홍석%손호%고경굉%하곤%설영리%설정%서초
冠心病%经皮冠状动脉介入治疗%可降解聚合物药物涂层支架
冠心病%經皮冠狀動脈介入治療%可降解聚閤物藥物塗層支架
관심병%경피관상동맥개입치료%가강해취합물약물도층지가
Coronary artery disease%Percutaneous coronary intervention%Biodegradable polymer drug-eluting stent
目的：评价重叠置入可降解聚合物涂层雷帕霉素洗脱支架（EXCEL支架）在治疗冠状动脉弥漫性长病变中（所需置入支架长度总和>60 mm）的安全性和有效性。<br> 方法：回顾性选取2010-08至2012-05期间在我院接受经皮冠状动脉介入治疗（PCI）重叠置入EXCEL支架的冠状动脉弥漫性长病变患者71例，平均年龄为（62.85±10.26）岁，其中74.56%为男性患者。研究终点为住院期间和术后2年随访期间的主要不良心脏事件（MACE）。<br> 结果：71例患者，平均每个靶病变置入支架（2.61±0.52）个，平均支架直径为（3.21±0.35）mm，平均每个病变总支架长度为（73.34±13.11）mm。住院期间MACE发生率为4.23%。院外2年随访期间的靶血管血运重建率和MACE发生率分别为9.86％和18.31%。Cox回归分析显示吸烟（风险比：12.102，95％可信区间1.460~100.309，P=0.021）、既往心肌梗死史（风险比：11.948，95％可信区间1.144~124.726，P=0.038）和既往PCI史（风险比：0.097，95％可信区间0.010~0.990，P=0.049）是影响院外MACE发生的独立危险因素。<br> 结论：EXCEL支架在治疗冠状动脉弥漫性长病变中的应用是安全和有效的，但远期随访显示MACE和靶血管血运重建的发生率明显增高。
目的：評價重疊置入可降解聚閤物塗層雷帕黴素洗脫支架（EXCEL支架）在治療冠狀動脈瀰漫性長病變中（所需置入支架長度總和>60 mm）的安全性和有效性。<br> 方法：迴顧性選取2010-08至2012-05期間在我院接受經皮冠狀動脈介入治療（PCI）重疊置入EXCEL支架的冠狀動脈瀰漫性長病變患者71例，平均年齡為（62.85±10.26）歲，其中74.56%為男性患者。研究終點為住院期間和術後2年隨訪期間的主要不良心髒事件（MACE）。<br> 結果：71例患者，平均每箇靶病變置入支架（2.61±0.52）箇，平均支架直徑為（3.21±0.35）mm，平均每箇病變總支架長度為（73.34±13.11）mm。住院期間MACE髮生率為4.23%。院外2年隨訪期間的靶血管血運重建率和MACE髮生率分彆為9.86％和18.31%。Cox迴歸分析顯示吸煙（風險比：12.102，95％可信區間1.460~100.309，P=0.021）、既往心肌梗死史（風險比：11.948，95％可信區間1.144~124.726，P=0.038）和既往PCI史（風險比：0.097，95％可信區間0.010~0.990，P=0.049）是影響院外MACE髮生的獨立危險因素。<br> 結論：EXCEL支架在治療冠狀動脈瀰漫性長病變中的應用是安全和有效的，但遠期隨訪顯示MACE和靶血管血運重建的髮生率明顯增高。
목적：평개중첩치입가강해취합물도층뢰파매소세탈지가（EXCEL지가）재치료관상동맥미만성장병변중（소수치입지가장도총화>60 mm）적안전성화유효성。<br> 방법：회고성선취2010-08지2012-05기간재아원접수경피관상동맥개입치료（PCI）중첩치입EXCEL지가적관상동맥미만성장병변환자71례，평균년령위（62.85±10.26）세，기중74.56%위남성환자。연구종점위주원기간화술후2년수방기간적주요불양심장사건（MACE）。<br> 결과：71례환자，평균매개파병변치입지가（2.61±0.52）개，평균지가직경위（3.21±0.35）mm，평균매개병변총지가장도위（73.34±13.11）mm。주원기간MACE발생솔위4.23%。원외2년수방기간적파혈관혈운중건솔화MACE발생솔분별위9.86％화18.31%。Cox회귀분석현시흡연（풍험비：12.102，95％가신구간1.460~100.309，P=0.021）、기왕심기경사사（풍험비：11.948，95％가신구간1.144~124.726，P=0.038）화기왕PCI사（풍험비：0.097，95％가신구간0.010~0.990，P=0.049）시영향원외MACE발생적독립위험인소。<br> 결론：EXCEL지가재치료관상동맥미만성장병변중적응용시안전화유효적，단원기수방현시MACE화파혈관혈운중건적발생솔명현증고。
Objective: To evaluate the efficacy and safety of overlapping biodegradable polymer sirolimus-eluting stents (EXCEL) in treating the patients with diffuse long coronary lesions (total stent length for per lesion>60 mm). <br> Methods: A total of 71 patients with diffuse long coronary lesions with overlapped EXcellstents implantation in our hospital from 2010-08 to 2012-05 were retrospectively studied. The average age of patients was (62.85 ± 10.26) years and 74.56%with male gender. The clinical endpoints were the major adverse cardiac events (MACE) at in-hospital time and at 2-year follow-up period. <br> Results: The average target lesion was implanted (2.61 ± 0.52) stents, the mean stent diameter was (3.21 ± 0.35) mm and the length was (73.34 ± 13.11) mm. The in-hospital MACE rate was 4.23%, the 2-year target vessel revascularization and MACE rates were 9.86%and 18.31%respectively. Cox regression analysis indicated that smoking (HR 12.102, 95%CI 1.460-100.309, P=0.021), previous history of MI (HR 11.948, 95%CI 1.144-124.726, P=0.038) and previous history of PCI (HR 0.097, 95%CI 0.010-0.990, P=0.049) were the independent risk factors of out of hospital MACE occurrence. <br> Conclusion: EXcellstent implantation was safe and effective for treating the patients with diffuse long coronary lesions, the long term follow-up study revealed that there was the increased risk for MACE and target vessel revascularization.
