雷帕霉素洗脱Cypher支架和裸支架治疗老年急性心肌梗塞患者的疗效评价  

Clinic efficacy of Cypher^(TM) stent and bare stent in elderly patients with acute myocardial infarction

作　　者：王智慧[1] 李淑梅[1] 邢玥[1] 

机构地区：[1]吉林大学第二医院心内科,吉林长春130041

出　　处：《吉林大学学报（医学版）》2006年第4期694-697,共4页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅资助课题(20050408-5)

摘　　要：目的:探讨在老年急性心肌梗塞(AMI)急诊经皮冠状动脉介入治疗(PCI)中植入雷帕霉素药物洗脱支架(CypherTM)及普通裸支架对C反应蛋白(CRP)及预后的影响。方法:45例老年急性AMI患者,分为CypherTM支架组(n=23)和裸支架组(n=22),所有患者在术前、术后6 h、术后1 d、术后7 d、术后1个月测定CRP,临床随访造影及主要心血管事件。结果:CypherTM支架组23例患者共植入27枚支架,术后TIMI血流3级23例,成功率100%;22例接受随访,随访时间3~11个月,无支架内再狭窄及心血管事件等发生。裸支架组22例患者共植入支架26枚,术后TIMI血流3级21例,临床成功率为95.5%;20例接受随访,随访时间5~13个月,2例患者发生支架内再狭窄(再狭窄率9.09%)。1例猝死,2例新生血管病变。两组术后6 h、术后1 d CRP水平与术前相比明显增高(P<0.05)。两组之间比较差异无显著性。结论:应用CypherTM支架治疗老年AMI近期安全有效。Objeetivo To investigate the effects of rapamycin eluting stent （Cypher^TM） and metal bare stent on the prognosis and C-reactive protein （CRP） in elderly patients with acute myocardial infarction （AMI）. Methods The immediate angiographic and clinic follow-up outcomes of 45 elderly patients with AMI reciving Cypher^TM and bare stent were retrospectively analyzed. CRP levels in Cypher^TM and bare stent groups were determined before implantation, 6 h, 1 d, 7 d and 30 d after implantation. Clinical follow-up and major coronary events analysis were developed after operation. Results 27 rapamycin eluting stents were implanted in patients of Cypher^TM group and 26 bare stents were implanted in patients of bare stent group. The Cypher^TM stents were successfully implanted with 100%. In patients of Cypher^TM group, no serious complications were found in the term of operation and in hospital. There was no restenosis, revascularization and events. In patients of bare stent group, except for 1 patients with sudden death, angina pectoris occurred in 2 patients, repeat angiography showed that there were new lesions in other coronary arteries of these patients. Restenosis attacked in 2 patients. The concentrations of CRP in Cypher^TM and bare stent groups 6 h and 7 d after operation were much higher than that of pr.e-operation （P〈0.05）. Gonetusion Repamycin eluting stent （Cypher^TM） shows a safety profile and potential efficacy in the treatment of elderly patients with AMI.

关 键 词：心肌梗塞/治疗 支架 C反应蛋白 

分 类 号：R542.22[医药卫生—心血管疾病]