药物支架和切割球囊在药物洗脱支架植入术后再狭窄中治疗效果比较

摘要

Objective To evaluate and compare the efficacy of drug-eluting stents (DES) and cutting balloon (CB) for the management of in-stent restenosis (ISR).Methods The immediate and (6.0 ± 1.4) months follow-up angiographic outcomes of 124 patients with ISR who were treated by drug eluting stents and cutting balloon were analyzed in this retrospective study.Results Baseline characteristics and angiographic profile were similar between these two groups.There was no statistically significant difference between two groups both in acute post procedure minimum lumen diameter (2.54 ± 0.45 vs 2.67 ± 0.48 mm,P ＞ 0.05) and diameter stenosis (23.5％ vs 21.8％,P ＞0.05) between DES and CB groups.At six-mouth follow-up study,however,the DES group showed significantly larger in the minimum lumen diameter (1.86 ±0.63 mm) than the CB group(1.34 ±0.71 mm) (P ＜0.01),and the diameter stenosis in the DES group was lower than that in the C B group(39.2％ vs 47.8％,respectively,P ＜ 0.05).Furthermore,the recurrent restenosis rate as well as lumen loss in the DES group (4.1％ and 0.52-±0.48 mm,respectively) were significantly lower compared with those of CB group (9.8％ and 0.74 ± 0.53 mm,respectively with P ＜ 0.01).Conclusion Drug-eluting stents is comparable with cutting balloon in terms of immediate outcomes but superior to the latter in terms of efficacy at 6-month follow-up.%目的 比较药物支架再植入和切割球囊2种方法,在药物洗脱支架植入术后再狭窄病人中的治疗效果.方法 回顾分析124例药物洗脱支架内再狭窄病人,经切割球囊或药物支架再次植入治疗即刻和术后随访结果.并于治疗时及术后(6.0±1.4)个月行冠脉造影检查.结果 2组病人的年龄、性别、既往病史及介入治疗前支架内再狭窄情况比较,差异无统计学意义(P＞0.05).介入治疗即刻切割球囊组与药物支架组:最小管腔直径[(2.54 ±0.45)mm vs (2.67 ±0.48)mm]及直径狭窄率(23.5％±l0.3％ vs 21.8％±9.4％)比较,差异无统计学意义(P＞0.05).术后6个月药物支架组的最小管腔直径(1.86±0.63)mm明显高于切割球囊组(1.34 ±0.71)mm(P＜0.01),且直径狭窄率显著低于切割球囊组(39.2％ vs 47.8％,P＜0.05).药物支架组复发再狭窄和晚期管腔丢失量均低于切割球囊组[4.1％ vs 9.8％,(0.52 ±0.48)mm vs (0.74 ±0.53)mm],差异有统计学意义(P＜0.01).结论 药物支架再植入相比于切割球囊治疗药物洗脱支架术后再狭窄,6个月后支架内再狭窄率低于切割球囊组.