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目的本研究旨在采用体积法血管内超声波(IVUS)来观察常规降压剂量坎地沙坦对冠状动脉支架内再狭窄的作用。方法本试验为前瞻性、安慰剂对照、随机分组研究,47例病人共计52处病变分为对照和坎地沙坦组,坎地沙坦组在介入治疗前至少3天按照血压水平给与4或8mg坎地沙坦,分别分析支架后和6个月随访时支架段的冠状动脉造影和血管内超声。增生内膜面积定义为支架面积减去管腔面积,以Simpson法则计算体积值,并以体积值除以支架长度作为平均体积值。结果两组病人和病变特征均相似,冠状动脉造影定量分析两组在随访时的最小管腔直径(对照组2.17±0.72mm,坎地沙坦组2.25±0.73mm,P=ns)和百分直径狭窄率(对照组25.2±16.5%,坎地沙坦组25.7±16.3%,P=ns)均无差异。IVUS分析,支架后平均管腔体积相等(对照组10.3±2.5,坎地沙坦组10.7±2.3mm3/mm,P=ns),随访时两组的平均内膜体积为3.1±1.3和3.3±1.0mm3/mm,平均管腔体积为7.9±3.0和8.2±2.3mm3/mm,均无显著性差异,6个月的靶病变血管重建率两组也相似,分别为15.6%和10.0%(P=ns)。结论在6个月随访期内,常规剂量的坎地沙坦可能对于预防支架内新生内膜增生无效。
OBJECTIVE: This study aimed to investigate the effect of candesartan on restenosis in coronary stents by volumetric intravascular ultrasound (IVUS). Methods This study was a prospective, placebo-controlled, randomized study of 47 patients with a total of 52 lesions divided into control and candesartan groups, candesartan at least 3 days prior to intervention, according to blood pressure levels to 4 Or 8 mg of candesartan were analyzed coronary angiography and intravascular ultrasound after stent and 6 months follow-up respectively. The area of proliferating endothelium is defined as the area of the stent minus the lumen area, the volume value is calculated using the Simpson’s rule, and the volume value is divided by the length of the stent as the average volume value. Results The characteristics of the two groups of patients were similar to those of the lesions. Coronary angiography was used to quantitatively analyze the minimum lumen diameter (2.17 ± 0.72mm in control group and 2.25 ± 0.73mm in candesartan group, P = ns) and percentage The diameter stenosis rate (25.2 ± 16.5% in the control group, 25.7 ± 16.3% in the candesartan group, P = ns) showed no difference. IVUS analysis, the average lumen volume was equal after stent (control group 10.3 ± 2.5, candesartan 10.7 ± 2.3mm3 / mm, P = ns), mean intimal volume at follow-up was 3.1 ± 1.3 and 3.3 ± 1.0mm3 / mm and average luminal volumes of 7.9 ± 3.0 and 8.2 ± 2.3mm3 / mm respectively. There was no significant difference between the two groups at 6 months (15.6% vs 10.0%, P = ns). Conclusions Candesartan at a normal dose may be ineffective in preventing neointimal hyperplasia within a 6-month follow-up period.