生物可吸收支架在NSTEMI患者临床应用的分析

Analysis of Clinical Application of Bioabsorbable Stents in NSTEMI Patients

摘要: 目的：探讨生物可吸收支架在非ST段抬高型心肌梗死患者的临床应用。方法：本研究将2020~2022年间于我院心内科就诊并行冠状动脉生物可吸收支架植入术的19名非ST段抬高型心肌梗死纳入生物可吸收支架组，行冠状动脉药物洗脱支架植入术的41名非ST段抬高型心肌梗死患者纳入药物洗脱支架组，比较两组患者术前24小时内及术后一周血常规衍生复合炎症指标、生化指标，对各组患者进行持续随访12月，随访各组患者主要心脑血管不良事件的发生。结果：两组患者术后1周血常规衍生复合炎症指标都较植入前下降，其中生物可吸收支架组患者炎症指标较药物洗脱支架组水平更低(P < 0.05)，随访12个月，生物可吸收支架组患者的心脑血管事件的发生率较药物洗脱支架组减少，但并无明显统计学差异(15.8% vs 29.3%, P > 0.05)。结论：对于非ST段抬高型心肌梗死患者而言，选择生物可吸收支架能够减轻机体的炎症应激反应，并且其在晚期心脑血管事件方面的表现不劣于药物洗脱支架，因此在临床应用中安全有效。

Abstract: Objective: To investigate the clinical application of bioabsorbable stent in patients with non-ST segment elevation myocardial infarction. Method: In this study, 19 patients with non-ST elevation myocardial infarction who were treated in the Department of Cardiology of our hospital during 2020~2022 and underwent coronary bioabsorbable stent implantation were included in the bioabsorbable stent group, and 41 patients with non-ST elevation myocardial infarction who underwent coronary drug-eluting stent implantation were included in the drug-eluting stent group. Complex inflammatory indicators and biochemical indicators derived from blood routine were compared between the two groups within 24 hours before surgery and one week after surgery. Patients in each group were continuously followed up for 12 months to follow up on the occurrence of major cardiovascular and cerebrovascular adverse events in each group. Result: The complex inflammatory indexes derived from blood routine tests in both groups were lower than before implantation 1 week after surgery, and the inflammatory indexes in the bioabsorbable stent group were lower than those in the drug-eluting stent group (P < 0.05). After 12 months of follow-up, the incidence of cardiovascular and cerebrovascular events in the bioabsorbable stent group was lower than that in the drug-eluting stent group. There was no significant difference (15.8% vs 29.3%, P > 0.05). Conclusion: For patients with non-ST-segment elevation myocardial infarction (NSTEMI), opting for bioresorbable scaffolds can alleviate the body’s inflammatory stress response, and their performance in terms of late cardiovascular and cerebrovascular events is non-inferior to drug-eluting stents, thus rendering them safe and effective in clinical application.