本文關(guān)鍵詞： 藥物洗脫球囊 西羅莫司藥物洗脫支架 支架內(nèi)再狹窄 療效　出處：《首都醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的本研究旨在對中國漢族人群中藥物洗脫球囊(drug-eluting balloon,DEB)和西羅莫司藥物洗脫支架(sirolimus-eluting stent,SES)治療支架內(nèi)再狹窄(in-stent restenosis,ISR)的療效進行比較。方法連續(xù)入選2014年9月至2015年6月,經(jīng)冠狀動脈造影確診ISR并接受DEB或SES治療的患者,根據(jù)所接受的治療策略將患者分別納入DEB組和SES組。記錄兩組患者住院期間主要不良心血管事件(major adverse cardiovascular event,MACE)發(fā)生率,并于術(shù)后12個月通過電話或門診進行臨床隨訪。結(jié)果共納入患者166例,包括DEB組63例,SES組103例;兩組中藥物洗脫支架(drug-eluting stent,DES)ISR患者116例,包括DEB組44例和SES組72例;根據(jù)Mehran分型,點狀病變患者33例,非點狀病變患者133例。住院期間兩組患者均未發(fā)生MACE。(13±2)個月臨床隨訪發(fā)現(xiàn),DEB組共發(fā)生MACE6例,包括非致死性心肌梗死(myocardial infarction,MI)2例和靶血管血運重建(target vessel revascularization,TVR)5例;SES組MACE 9例,包括全因死亡3例和TVR 7例;兩組間MACE發(fā)生率差異無統(tǒng)計學(xué)意義(9.7%vs.9.2%,P=0.92),然而DEB組的無心血管事件生存率并未獲得非劣于SES組的結(jié)果(90.3%vs.90.8%,P非劣效=0.23)。DES-ISR患者中,DEB組和SES組的MACE發(fā)生率無明顯差異(7.0%vs.10.3%,P=0.74),而無事件生存率DEB組并未獲得非劣于SES組的結(jié)果(93.0%vs.89.7%,P非劣效=0.09)。在非點狀病變患者中,兩組間MACE發(fā)生率差異也無統(tǒng)計學(xué)意義(10.4%vs.8.6%,P=0.76),而DEB組患者的無心血管事件生存率也并未獲得非劣于SES組患者的結(jié)果(89.6%vs.91.4%,P非劣效=0.34)。多因素Cox回歸分析發(fā)現(xiàn)使用DEB或SES不是患者1年隨訪MACE發(fā)生的獨立預(yù)測因素(P=0.20)。結(jié)論中國漢族人群中紫杉醇藥物洗脫球囊與西羅莫司藥物洗脫支架治療支架內(nèi)再狹窄的療效差異無統(tǒng)計學(xué)意義,且在DES-ISR和非點狀病變患者中兩種治療方式也無明顯差異。
[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 鹵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.
【學(xué)位授予單位】：首都醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R54

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相關(guān)期刊論文 前5條

1 崔孔勇;呂樹錚;柳弘;宋現(xiàn)濤;;藥物洗脫球囊治療支架內(nèi)再狹窄的研究進展[J];心肺血管病雜志;2016年03期

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本文編號：1539015