急性心肌梗死介入治疗后冠状动脉支架内亚急性血栓分析  

The clinical study of subacute thrombosis in coronary stents after percutaneous coronary intervention of acute myocardial infarction

作　　者：熊龙根[1] 陆东风[1] 刘世明[1] 李国强[1] 许博裳[1] 

机构地区：[1]广州医学院第二附属医院心内科,广东省广州市510260

出　　处：《中国心血管病研究》2006年第11期815-817,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨急性心肌梗死(AMI)支架置入术后支架内亚急性血栓形成的相关因素。方法612例AMI支架置入术后患者,4例发生支架内亚急性血栓,分析血栓形成的相关因素。结果4例AMI患者在介入治疗后2～13d发生原梗死部位的再次AMI,经冠状动脉造影证实支架内血栓形成,发生率近0.7%,3例裸金属支架,1例药物洗脱支架。3例合并高血压,2例合并糖尿病。1例支架贴壁不完全,2例补救性PCI因出血并发症未规范抗凝、抗血小板治疗,再次PCI后,1例因左心衰死亡。结论AMI后支架内亚急性血栓多发生于合并高血压、糖尿病患者,以及介入治疗后明显残余狭窄、血栓残留病变患者,合理选用支架,规范抗凝、抗血小板治疗是防止发生支架内亚急性血栓的关键措施。Objective To study the factors of subacute thrombosis in coronary stents after percutaneous coronary intervention（PCI） of acute myocardial infarction（AMI）. Methods A total of 612 patients with AMI who underwent PCI ,and subacute thrombosis in coronary stent happened in 4 patients. The factors related to thrombosis were studied. Results Subacute thrombosis in stents had been happened in 4 AMI patients after 2 to 13 days of PCI .3 with bare- metal stent, 1 with drug- eluting stent. 3 with hypertension, 2 with diabetes. Stent was not complete expanted in 1 patient. 2 patients were not complete treated with anti-coagulant and anti- platelet. Second PCI were performed on 4 patients, 1 patient died of cardiol failure. Conclusion Subacute thrombo in coronary stents of AMI probably correlate with following factors： hypertension,diabetes, remain stenosis and thrombus coronary lesions after PCI.Select stent reasonably, general anti-coagulant and anti- platelet are important methods of prevent subacute thrombosis in coronary stents.

关 键 词：心肌梗塞 血管成形术 经腔 经皮冠状动脉 支架 血栓形成 

分 类 号：R542.22[医药卫生—心血管疾病]