心肌桥介入治疗后支架内再狭窄及其再次治疗效果观察.docVIP

心肌桥介入治疗后支架内再狭窄及其再次治疗效果观察 　　［摘 要］ 目的 观察心肌桥病变介入治疗的再狭窄率及其治疗效果 。方法 选择有症状的单纯心肌桥改变且收缩期严重狭窄(≥95%)者 17例作治疗组(A组)，对照组选择单纯前降支动脉粥样硬化严重狭窄(≥70%)者54例(B组)， 两组均应 用普通冠脉支架介入治疗。结果 两组介入手术均成功，两组支架植入后 的血管内径及支架长度比较无显著差别(P＞0.05)。A组6个月内8例(47%)出现再狭窄，B组8 例再狭窄(14.8%)，A组和B组的再狭窄率有显著差别(P＜0.05)；两组中再狭窄病人均 再次接受治疗。平均随访20月，A组8例中7例未再发生支架内狭窄及心绞痛事件，1例再次支 架内狭窄，B组再次介入治疗的6例中1例再次支架内狭窄。结论 心肌桥病 变的介入治疗远期疗效尚好，但远期支架内再狭窄率较高，需再次介入治疗。 　　［关键词］ 心肌桥；冠脉内支架植入术；冠状动脉粥样硬化性???脏病 　　中图分类号：R542.2 文献标识 码：A 文章编号：1009_816X(2007)04_0229_03 　　Observation of Stent Restenosis after Stent Implantation for Myocardi al Bridge Lesion. MA Hui, WANG Ning-Fu, PAN Hao, et al. Department of Cardiology, Hangzhou First Peoples Hospital, Zhejiang 310006, China 　　［Abstract］ Objective To assess the efficacy of long term stent implantation for myocardial bridge lesion and severe atherosclerosis lesions in the segments proximal to the myocardial bridge. Methods The stu dy population consisted of 76 patients including 17 patients with symptomatic my ocardial bridge lesion of luminal narrowing more than 95 percent (Group A) and 5 9 patients with severe atherosclerosis lesion of luminal narrowing more than 70 percent (Group B). All lesions were in left anterior descending coronary artery and treated with coronary stent by standard interventional technique. Quantitati ve coronary angiography was performed before and after stent implantation and ag ain at six months afterwards. Clinical follow up was done up to 20 months. Results All procedures were successful in two groups. There was no si gnificant difference in luminal diameter and stent diameter immediately after st ent implantation (P＞0.05). At 6 months, restenosis occurred in 8 patients of group A(47%), and 8 cases in group B(14.8%). The rate of restenosis was sign ificantly higher in group A than in group B (P＜0.05). In group A, 7 resten osis patients were performed additional ballon dilating in stent and 1 patient w as reimplanted another DES stent. On clinical evaluation at 20 months, all pa