目的：评价年龄﹥75岁老年冠心病患者置入国产BuMA生物降解药物涂层冠脉支架( BuMA支架)后,缩短氯吡格雷用药时间的短期临床疗效和安全性。方法选择2012年11月至2013年7月于开封市中心医院就诊的年龄﹥75岁、已明确诊断冠心病需行冠状动脉造影( coronary angiography,CAG)及经皮冠状动脉介入治疗( percutaneous coronary intervention, PCI )的老年患者100例,均置入BuMA支架,随机分为观察组50例(口服氯吡格雷75 mg,每日1次,维持9个月)和对照组50例(口服氯吡格雷75 mg,每日1次,维持12个月),比较术后12个月内心绞痛、急性心肌梗死、临床出血事件等发生率及复查冠状动脉造影情况。结果观察组术后3个月再发心绞痛4例(8.0%)；术后12个月复查CAG患者45例(90.0%),原支架均未见明显狭窄,余冠状动脉病变血管稍有进展。对照组术后4个月再发心绞痛3例(6.0%)；术后12个月复查CAG患者42例(84.0%),均未见异常。随访12个月内两组均无临床出血事件、迟发性支架内血栓、非致死性心肌梗死及心原性死亡等不良事件发生。结论年龄﹥75岁老年冠心病患者置入国产BuMA支架后,缩短氯吡格雷用药时间在短期内安全有效。%Objective To evaluate the clinical efficacy and safety of domestic BuMA biodegradable drug eluting coronary stent in elderly coronary heart disease patients over 75 years old with shortened duration of clopidogrel treatment. Methods 100 elderly patients who received coronary angiography and PCI were included, and they were randomly divided into the observation group ( n=50, received oral clopidogrel for 9 months) and the control group (n=50, received oral clopidogrel for 12 months). The occurance of angina pectoris, AMI, bleeding events and the results of control angiography were compared between the two groups after 12 months of follow-up. Results All the 100 patients were followed up in 12 months after discharge. 4 patients ( 8. 0%) in the observation group and 3 patients ( 6. 0%) in the control group had recurrent angina. Control coronary angiography 12 months later showed no restenosis in the stents. There was no significant difference between the two groups in the recurrence of angina pectoris and coronary stent restenonsis. No acute myocardial infarction,cliniacl bleeding events and late stent thrombosis occurred in the two groups. Conclusions The application of the domestic BuMA biodegradable drug eluting stent for the treatment of coronary heart disease patients over 75 years old is safe and effective with shortened duration of clopidogel treatment.
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