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肌肉注射甲泼尼龙预防裸金属不锈钢支架冠状动脉支架置入术后再狭窄的疗效:一项双盲、随机、对照临床试验。

Efficacy of intramuscular methyl prednisolone in preventing restenosis after coronary artery stenting with bare-metal stainless steel stent: a double-blind, randomised, controlled clinical trial.

作者信息

Namdari M, Ghafarzadeh M, Nikoo M A

机构信息

Department of Cardiology, Lorestan University of Medical Sciences, Khoramabad, Iran.

出版信息

Cardiovasc J Afr. 2011 Mar-Apr;22(2):67-9. doi: 10.5830/cvja-2010-039.

Abstract

The aim of this study was to compare the mid-term outcome of patients receiving intramuscular methyl prednisolone before and after the procedure of coronary artery stenting. The study was conducted during 2007 and 2008 and compared the two arms of the study for the rate of restenosis six months after stenting. The control arm (100 patients) received only the usual preventive measures but the glucocorticoid arm (100 patients) received two doses of intramuscular methyl prednisolone (40 mg) at two-week intervals, the first at the time of the procedure. They also received the usual preventive measures There was no statistically significant difference between the two arms for the rate of restenosis. When separately analysing for three vessels and for gender, there was no statistically significant difference either. Lowering the dose of corticosteroid would greatly reduce the efficacy for preventing restenosis after coronary artery stenting. Therefore, if we are to achieve acceptable effectiveness with intramuscular prednisolone, we should administer increased doses at shorter intervals, which could be the target of further studies. However, there would be more chance of side effects with increased frequency of dosing.

摘要

本研究的目的是比较冠状动脉支架置入术前和术后接受肌肉注射甲基强的松龙的患者的中期结局。该研究于2007年至2008年期间进行,比较了研究的两组在支架置入术后六个月的再狭窄率。对照组(100例患者)仅接受常规预防措施,而糖皮质激素组(100例患者)每隔两周接受两剂肌肉注射甲基强的松龙(40毫克),第一剂在手术时注射。他们也接受常规预防措施。两组之间的再狭窄率没有统计学上的显著差异。在分别对三支血管和性别进行分析时,也没有统计学上的显著差异。降低皮质类固醇的剂量将大大降低冠状动脉支架置入术后预防再狭窄的疗效。因此,如果我们要用肌肉注射强的松龙达到可接受的效果,我们应该以更短的间隔给予更高的剂量,这可能是进一步研究的目标。然而,给药频率增加会有更多副作用的可能性。

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