永久性与生物可降解聚合物西罗莫司药物洗脱支架远期结果的比较性研究

发布时间：2018-06-17 21:29

本文选题：西罗莫司药物洗脱支架 + 永久聚合物　；参考：《大连医科大学》2012年硕士论文

【摘要】：研究背景：自第二代药物洗脱支架的应用以来，争论日益激烈。几项大规模随机实验已经证实了新型药物洗脱支架的安全性及有效性。Partner支架（涂有永久性聚合物）和Excel支架（涂有生物可降解聚合物）是两种不同类型由中国生产的西罗莫司洗脱支架。中期和长期疗效已经被研究并证实有前景，然而，远期疗效还不清楚。本研究旨在研究在现行临床实践中，这两种类型药物洗脱支架的远期效果。方法：本研究入选自2006年12月至2011年12月就诊于大连医科大学附属第二医院，，行PCI治疗植入Partner或Excel支架的病人。病人根据植入支架的类型进行分组，并回顾性收集临床危险因素，同时进行随访。比较随访60个月主要不良心血管事件和支架内血栓形成的发生率（主要不良心血管事件：猝死，心肌梗死，靶血管重建）结果：447例病人应用Partner支架，536例病人应用Excel支架，161例病人同时应用Partner和Excel支架。随访60个月MACE的发生率Partner组7.6%,Excel组6.9%(HR0.901, CI0.56-1.46, P=0.671)。心源性死亡、心肌梗死、靶血管重建的发生率分别为：2.2%versus1.7%(HR0.746, CI0.3-1.8, P=0.527),2.23%versus2.61%(HR1.17, CI0.51-2.7, P=0.705) and2.68%versus1.42%(HR0.55, CI0.223-1.365, P=0.187)。支架内血栓形成的发生率0.44%versus0.74%（HR1.67,CI0.305-9.17, P=0.549）. 结论：多聚物涂层可降解Excel药物洗脱支架和永久性涂层多聚物Partner支架真实世界中、远期MACE和支架内血栓形成的发生率较低。两种药物洗脱支架都可以安全有效地用于临床以改善远期预后。
[Abstract]:Background: since the application of the second generation drug eluting stent, the controversy has become increasingly fierce. Several large scale randomized trials have confirmed the safety and effectiveness of new drug-eluting stents. Partner stents (coated with permanent polymers) and Excel stents (coated with biodegradable polymers) are two different types of drug-eluting stents from China Sirolimus eluting stent. Medium-and long-term outcomes have been studied and proven promising, however, long-term outcomes are unclear. The aim of this study was to study the long-term effects of these two drug-eluting stents in current clinical practice. Methods: patients with partner or Excel stents were enrolled in the second affiliated Hospital of Dalian Medical University from December 2006 to December 2011. Patients were grouped according to the type of stent implantation, and clinical risk factors were collected retrospectively and followed up. To compare the incidence of major adverse cardiovascular events and in-stent thrombosis (major adverse cardiovascular events: sudden death, myocardial infarction) at 60 months follow-up. Results: one hundred and forty-seven patients were treated with partner stents and 536 patients with Excel stents. 161 patients were treated with both partner and Excel stents. The incidence of Mace in partner group was 7.6g / min. The HR0.901in Excel group, 0.901in CI 0.56-1.46in group C, 0.671 in group C were followed up for 60 months. The incidences of cardiogenic death, myocardial infarction and target vessel reconstruction were: 1: 2.2 versus 1.7 and HR0.746, CI0.3-1.8, P0. 527 and 2.23versus 2.61HR1.17, CI0.51-2.7, P0. 705) and 2.68versus 1.42HR0.55, CI0.223-1.365, PJ 0.187. The incidence of thrombus in stent was 0.44 versus 0.74% HR1.67 CI 0.305-9.17, and Ph 0.549%. Conclusion: in the real world, the incidence of long-term Mace and in-stent thrombosis is lower in polymer coated biodegradable Excel drug-eluting stents and permanent coated polymer partner stents. Both drug eluting stents can be used safely and effectively to improve long-term prognosis.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R318.08

【共引文献】