冠心病介入治疗中的药物支架(一)  

Drug-Eluting Stent in Percutaneous Coronary Intervention(PCI)

作　　者：吴永健[1] 宋光远[1] 杨跃进[1] 

机构地区：[1]中国医学科学院阜外心血管病医院,北京100037

出　　处：《中国医疗器械信息》2005年第2期45-46,50,共3页China Medical Device Information

摘　　要：介入心脏病学始于27年前,自Andreas Gruntzig在人身上进行第一例经皮冠脉内成形术开始,随着血管病理学知识的扩展和医学技术的巨大进步,介入心脏病学已经成为冠心病的主要治疗手段。近年来,随着药物支架的出现,我们进入了介入心脏病学的一个新的时期,我们第一次可以不仅处理动脉壁的弹性回缩,还可以处理血管壁的病理生物学变化,使防治再狭窄更进一步。现在在需要进行介入手术治疗的病人中,药物支架成了治疗的新标准。这篇文章回顾了介入心脏病学的发展历史,讲述了现在的药物支架的特点并预测了药物支架的发展方向。文章从药物支架的结构入手,比较了临床上应用的主要几种药物支架,并阐述了目前主要的几个评价药物支架疗效和安全性的临床试验。随着药物支架的不断发展,介入心脏病学将会迎来更多的革命,药物支架取代裸支架是一种必然,在未来药物支架将主导整个冠心病介入治疗。Interventional cardiology made its debut 27 years ago, when Andreas Gruntzig performed th first percutaneous transluminal coronaryangioplasty in a human. Since then rapid expansion of our knowledge of vascular pathology and its reponse to therapy, combined withtremendous advances in medical technology, has propelled this once obscure discipline to the forefront of treatment of symptomaticcoronary artery disease. With the recent advent of drug-eluting stents, we are at the dawn of a new era of interventional cardiology. Forthe first time we are able not only to treat the mechanical consequences of coronary artery disease but also to control the pathobiologicalresponse of the vessel wall. In nowadays, for patients with coronary artery disease undergoing percutaneous intervention, drug-elutingstents (DESs) have rapidly become the standard of care. This article reviews the currently available delivery-platform/drug-carrier-vehicle combinations, and those expexted to become available in the future. It describes the structure of the drug-eluting stents(DESs),which including delivery-platform, the drug-carrier-vehicle and the drugs used to prevent renstenosis after PCI. In order to show it moreclearly, the auther compares the major DESs used in PCI, such as Taxus, Cypher, Endeavor and Firebird. And it also reviews most ofthe popular randomized clinical trails including RAVEL, SIRIUS, and TAXUSⅡ-Ⅵ etc, and which includes clinical andangiographic outcomes. All of the clinical trails evaluates DESs in terms of the drugs involved, the delivery platform, efficacy, andsafety. With the recent development of the DES, an even more spectacular evolution is taking place that will forever change thelandscope of interventional cardiology.

关 键 词：冠心病介入治疗 药物支架 介入心脏病学 经皮冠脉内成形术 介入手术治疗 血管病理学 病理生物学 医学技术 治疗手段 弹性回缩 临床试验 动脉壁 血管壁 再狭窄 安全性 裸支架 文章 

分 类 号：R541.4[医药卫生—心血管疾病] R654.2[医药卫生—内科学]