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|本期目录/Table of Contents|

氮氧化钛生物有效性支架与雷帕霉素药物洗脱支架临床应用的比较

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第3期
页码:
393-395,400
栏目:
临床研究
出版日期:
2010-04-06

文章信息/Info

Title:
Comparison between titanium nitric oxide biological active stent and sirolimus-eluting stent in clinical practice
作者:
张孝忠; 张晋; 张军; 王红; 原新茹
解放军军事医学科学院 307医院心脏内科，北京 100071
Author(s):
ZHANG Xiao-zhong;  ZHANG Jin;  ZHANG Jun;  WANG Hong;  YUAN Xin-ru
Department of Cardiology, PLA 307 Hospital, Academy of Military Medical Sciences, Beijing 100071, China
关键词:
冠脉血运重建; 氮氧化钛生物有效性支架; 雷帕霉素药物洗脱支架
Keywords:
coronary revascularization;  titanium nitric oxide biological active stent;  sirolimus-eluting stent
分类号:
R541.405
DOI:
-
文献标识码:
A
摘要:
目的:对比氮氧化钛生物有效性支架（Titan2-BAS）与雷帕霉素药物洗脱支架（sirolimus-eluting stent,SES）在冠状动脉血运重建方面的临床疗效。方法: 冠心病患者141例，根据植入的支架不同分为A组（Titan2-BAS）87例，B组（SES）54例，A组病变内径(3.1±0.4)mm，长度(24±3)mm，B组病变内径(3.0±0.5)mm，长度(22±4)mm，两组无显著差异。均采用经桡动脉或尺动脉途径冠脉血运重建。A组阿司匹林与氯吡格雷治疗1～3月，B组至少12月。计算A，B两组支架病变的通过率、早期支架内血栓发生率及随访MACE发生率（指死亡、急性心肌梗死、靶血管重建等）。结果: A组146处>75%狭窄病变共植入Titan2-BAS 168枚，1枚支架未能通过病变（RCA），通过率99.3%；B组86处病变共植入SES94枚，通过率100%，两组无显著差异。随访1～17（平均5.8）月。两组均无死亡病例；A组无急、晚期血栓。B组1例术后2 d出现支架内血栓；A组1例术后3月行靶血管重建，B组无靶血管重建；两组MACE发生率无显著差异。结论: Titan2-BAS与SES在冠脉血运重建方面的近期及远期疗效相近，Titan2不增加MACE发生率。
Abstract:
AIM: To compare the clinical efficacy of titanium nitric oxide biologically active stents (Titan2-BAS) and sirolimus-eluting stents (SES) in coronary revascularization. METHODS: One hundred and forty one patients with coronary artery disease were enrolled. Eighty seven patients were enrolled in group A treated with titanium nitric oxide biological active stents, whereas the other 54 patients were enrolled in group B treated with sirolimus-eluting stents. The reference vessel diameter was (3.1±0.4) mm and lesion length was (24±3) mm in group A, whereas diameters and length were (3.0±0.5) mm and (22±4) mm long, respectively, in group B with no significant difference between groups. All stents were implanted through either radial or ulnar artery approach. Patients in group A were given aspirin and clopidogrel for 1 to 3 months, whereas patients in group B used these for at least 12 months. The stent delivery success rate, incidence of early in-stent thrombosis and MACE (death, acute myocardial infarction, and target vessel revascularization) were analyzed in both groups during follow-up. RESULTS: In group A, 168 Titan2-BAS were implanted in 147 lesions with stenosis >75%. One stent failed to cross the lesion, the delivery success rate being 99.3%. In group B, 94 units of SES were implanted in 86 lesions, the delivery success rate being 100%. No significant difference was observed between groups. Follow-up period ranged from 1 to 17 months, with an average of 5.8 months. No deaths were found in both groups. There was no acute or late in-stent thrombosis in group A but one patient in group B suffered from in-stent thrombosis 2 days after the procedure. One patient underwent revascularization 3 months after the procedure in group A and no revascularizations were done in group B. No significant difference on MACE was found between groups. CONCLUSION: Our results suggest that Titan2-BAS is as good as SES in short- and long-term efficacy in coronary revascularization. Application of Titan2-BAS will not increase MACE.

参考文献/References

［1］张孝忠，张晋，张军，等. 氮氧化钛涂层支架在经桡/尺动脉冠状动脉血运重建方面的初步应用［J］. 中国综合临床， 2008， 24（8）：804-805.

［2］张孝忠，张晋，张军，等. 氮氧化钛涂层支架在老年经桡（尺）动脉冠状动脉血运重建中的应用［J］. 第四军医大学学报，2008，29（1）：F003.

［3］Windecker S, Simon R, Lins M, et al. Randomized comparison of a titanium-nitride-oxide-coated stent with a stainless steel stent for coronary revascularization the TiNOX trial［J］. Circulation, 2005, 111(20):2617-2622.

［4］Windecker S, Isabella M, Pasquale GD, et al. Stent coating with titanium-nitride-oxide for reduction of neointimal hyperplasia ［J］. Circulation, 2001, 104(8):928-933.

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［6］ Bhatt DL, Flather MD, Hacke W, et al. Patients with prior myocardial infarction, stroke, or symptomatic peripheral arterial disease in the CHARISMA trial［J］. J Am Coll Cardiol, 2007, 49(19):1982-1988.

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备注/Memo

备注/Memo:
收稿日期：2008-09-12.作者简介：张孝忠，主任医师，硕士Email：z947136@sohu.com
更新日期/Last Update: 2010-04-09