Objective To evaluate the long term clinical affection of drug eluting stent ( DES )and bare metal stent ( ISR )for coronary heart disease. Methods 2950 patients with coronary heart disease was treated by DES ( n = 2734 )or BMT( n =216 ). The incidence of ISR, acute myocardial infarction, PCI/CABG and mortality were observed and analyzed. Results More patients receiving BMS experienced ISR compared with patients receiving DES ( 9. 58% vs. 18. 98% , 18. 32% vs. 31. 94% , P <0. 05 ); there were no significant difference between patients who treated with BMS and DES in acute myocardial infarction, PCI/CABG and mortality at half one years ( P >0.05 ), but more patients receiving BMS compared with patients receiving DES in one years follow up ( P <0. 05 ). Stent diameter≤3 mm, age and smoking are the independent risk factors for the ISR. Conclusion The long term clinical effecting of drug eluting stent was superior than bare metal stent, me-ta-analysis were needed for further proving this conclusion.%目的 探讨药物洗脱性支架(DES)和裸金属支架(BMS)治疗冠状动脉狭窄的远期疗效.方法 对成功进行DES植入术患者2734例和BMS植入患者216例术后6个月、1年进行随访,观察其支架内再狭窄(ISR)发生率、急性心肌梗死发生率、冠状动脉旁路移植(CABG)或再次经皮冠状动脉介入治疗(PCI)治疗率、病死率,分析术后再狭窄的独立危险因素.结果 术后6个月、1年时DES组ISR发生率均低于BMS组(9.58% vs 18.98%,18.32% vs 31.94%),差异有统计学意义(P<0.05);随访6个月时,急性心肌梗死发生率、CABG或再次PCI治疗率和病死率方面比较差异无统计学意义(P>0.05),但是随访1年后,其差异有统计学意义(P<0.05);多因素分析发现,支架直径≤3 mm、吸烟和年龄是支架植入术后发生再狭窄的独立危险因素.结论 在冠状动脉狭窄的治疗中,DES的远期疗效优于BMS,但临床应用还需要进一步的循证医学研究证据.
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