药物洗脱球囊与西罗莫司药物洗脱支架治疗支架内再狭窄疗效的比较

发布时间：2018-02-26 17:26

本文关键词： 药物洗脱球囊西罗莫司药物洗脱支架支架内再狭窄疗效　出处：《首都医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的本研究旨在对中国汉族人群中药物洗脱球囊(drug-eluting balloon,DEB)和西罗莫司药物洗脱支架(sirolimus-eluting stent,SES)治疗支架内再狭窄(in-stent restenosis,ISR)的疗效进行比较。方法连续入选2014年9月至2015年6月,经冠状动脉造影确诊ISR并接受DEB或SES治疗的患者,根据所接受的治疗策略将患者分别纳入DEB组和SES组。记录两组患者住院期间主要不良心血管事件(major adverse cardiovascular event,MACE)发生率,并于术后12个月通过电话或门诊进行临床随访。结果共纳入患者166例,包括DEB组63例,SES组103例;两组中药物洗脱支架(drug-eluting stent,DES)ISR患者116例,包括DEB组44例和SES组72例;根据Mehran分型,点状病变患者33例,非点状病变患者133例。住院期间两组患者均未发生MACE。(13±2)个月临床随访发现,DEB组共发生MACE6例,包括非致死性心肌梗死(myocardial infarction,MI)2例和靶血管血运重建(target vessel revascularization,TVR)5例;SES组MACE 9例,包括全因死亡3例和TVR 7例;两组间MACE发生率差异无统计学意义(9.7%vs.9.2%,P=0.92),然而DEB组的无心血管事件生存率并未获得非劣于SES组的结果(90.3%vs.90.8%,P非劣效=0.23)。DES-ISR患者中,DEB组和SES组的MACE发生率无明显差异(7.0%vs.10.3%,P=0.74),而无事件生存率DEB组并未获得非劣于SES组的结果(93.0%vs.89.7%,P非劣效=0.09)。在非点状病变患者中,两组间MACE发生率差异也无统计学意义(10.4%vs.8.6%,P=0.76),而DEB组患者的无心血管事件生存率也并未获得非劣于SES组患者的结果(89.6%vs.91.4%,P非劣效=0.34)。多因素Cox回归分析发现使用DEB或SES不是患者1年随访MACE发生的独立预测因素(P=0.20)。结论中国汉族人群中紫杉醇药物洗脱球囊与西罗莫司药物洗脱支架治疗支架内再狭窄的疗效差异无统计学意义,且在DES-ISR和非点状病变患者中两种治疗方式也无明显差异。
[Abstract]:Objective to compare the efficacy of drug eluting balloon eluting on DEB (drug eluting balloon) and sirolimus-eluting stentoses (SESs) in the treatment of restenosis in-stent restenosism (ISR) in Chinese Han population. Patients with ISR diagnosed by coronary angiography and treated with DEB or SES were included in the DEB group and SES group according to the treatment strategy. The incidence of major adverse cardiovascular events in the two groups was recorded. A total of 166 patients were included in the study, including 63 patients in the DEB group and 103 in the DEB group. 116 patients with drug-eluting stents were included in the two groups, including 44 patients in the DEB group and 72 in the SES group, according to the Mehran classification. 33 patients with punctate lesions and 133 patients with non-punctate lesions. No MACE.(13 卤2) occurred in both groups during hospitalization. There were 9 cases of MACE in the group of non-fatal myocardial infarction, including 2 cases of myocardial infarction and 5 cases of target vessel revascularization TVRN, including 3 cases of total death and 7 cases of TVR. There was no significant difference in the incidence of MACE between the two groups. However, the cardiovascular event-free survival rate in the DEB group was not worse than that in the SES group. There was no significant difference in the incidence of MACE between the DEB group and the SES group, but there was no significant difference in the incidence of MACE between the DEB group and the SES group. The survival rate of DEB group was not inferior to that of SES group. There was no significant difference in the incidence of MACE between the two groups. There was no significant difference in the incidence of MACE between the two groups. The cardiovascular event free survival rate in the DEB group was not worse than that in the SES group. Multivariate Cox regression analysis showed that DEB or SES was not a disease. Conclusion there is no significant difference between paclitaxel eluting balloon and sirolimus-eluting stent in the treatment of stent restenosis. There was no significant difference between the two treatments in DES-ISR and non-point lesions.
【学位授予单位】：首都医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R54

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