摘要
目的利用血管内超声观察冠状动脉钙化病变对药物洗脱支架植入后内膜增生的作用。方法对97例(99处病变)冠心病患者在药物洗脱支架植入后8个月利用血管内超声(IVUS)测定支架近端、支架远端和支架内管腔最小处血管段外弹力膜(EEM)横截面积(CSA),支架内CSA,管腔CSA,新生内膜面积,支架最大直径及最小直径,并推算支架对称指数。根据IVUS检测血管钙化的情况将支架植入段血管分为钙化病变组和非钙化病变组,观察钙化病变对支架植入后内膜增生的作用。结果99处病变中有14例支架内内膜增生。与非钙化组患者比较,钙化病变组支架植入后支架两端支架内CSA相似:支架近端为(7·30±1·94)mm2和(6·58±1·96)mm2;支架远端为(6·74±2·02)mm2和(6·14±1·82)mm2。但支架内最小CSA明显减小[(6·10±1·87)mm2和(4·97±1·51)mm2,P<0·05]且对称性较差(对称指数0·92±0·07和0·87±0·09,P<0·05),但内膜面积反而显著减少(0·53±1·50)mm2与(0·02±0·20)mm2。结论冠状动脉药物洗脱支架治疗钙化病变支架扩张程度和对称性均较差,但是与非钙化病变患者比较,内膜增生反而减少。
Objective To investigate the impact of calcified lesion on the intimal hyperplasia after implantation of drug eluting stent. Methods Ninety-nine rapamycin-eluting stents were implanted into the left anterior descending branches of coronary artery of 97 patients with 99 lesions. Eight months later intravascular ultrasound （IVUS） was used to examine the cross section area （CSA） of the external elastic membrane （EEM） at the stent inlet and at the stent outlet, in-stent CSA, CSA of the lumen, area of neointima （ in-stent area minus lumen CSA）, the maximum and minimum diameters of stent, and symmetry index of stent （ minimal diameter of stent/maximum diameter of stent ）. Results Forty-one lesions were calcified and 58 non-calcified. Fourteen of the 99 lesions in the 97 patients developed intimal hyperplasia. The inlet stent CSA of the calcified group was （7.30 ± 1.94） mm^2, similar to that of the non-calcified group （6.58 ± 1.96） mm^2; the outlet CSA of the calcified group was （6.74 ±2.02） mm^2, similar to that of the non-calcified group （6.14 ± 1.82） mm^2. The minimum stent CSA of the calcified group was （4.97 ± 1.51 ） mm^2, significantly smaller than that of the non-calcified group （ 6. 10 ± 1.87 ） mm^2 （ P 〈 0.05 ） , the symmetry index of the calcified group was 0.92 ± 0.07, significantly lower than that of the non-calcified group （0.92 ± 0.07, P 〈 0.05 ） , and the intimal area of the calcified group was （ 0.02 ± 0. 20） mm^2, significantly smaller than that of the non-calcified group （ 0.53 ± 1.50 ） mm^2 （ P 〈 0.05 ）. Conclusion Drug eluting stent implantation in the patients with calcified lesions has a less stent CSA and poor symmetry, and less intimal hyperplasia compared with those in the non-calcified lesions.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2006年第16期1118-1121,共4页
National Medical Journal of China
