急诊经皮冠状动脉介入治疗中应用雷帕霉素洗脱支架的疗效观察  

Effectiveness of sirolimus-eluting stents in emergency percutaneous coronary intervention

作　　者：刘如辉[1] 赵明中[1] 刘洋[1] 马文林[1] 邓兵[1] 许嘉鸿[1] 蒋金法[1] 胡大一[1] 

机构地区：[1]同济大学附属同济医院心内科,上海200065

出　　处：《中华全科医师杂志》2007年第12期731-733,共3页Chinese Journal of General Practitioners

基　　金：同济大学青年优秀人才基金(2006KJ071)

摘　　要：目的观察急性心肌梗死(AMI)患者经皮冠状动脉介入治疗中应用雷帕霉素洗脱支架的疗效及安全性。方法采用对照研究方法,急诊介入治疗时将220例 AMI 患者分为金属裸支架组和雷帕霉素药物洗脱支架组,比较治疗1个月和6个月后两组间的死亡率、重要心脏不良事件(MACE)和6个月时靶血管重建术等情况。结果随访1个月和6个月后,两组总死亡率和 MACE发生率差异均无统计学意义。裸支架组在6个月总死亡人数为3人,均为心源性死亡,死亡率为2.8%。药物支架组6个月总死亡人数为5人,死亡率为4.5%。然而,药物支架组再狭窄率比金属裸支架组明显降低(6.0%比16.1%,P<0.05)。结论雷帕霉素药物支架应用于 AMI 病变是安全有效的,与裸支架相比其能明显降低术后再狭窄率和再次血运重建率。Objective To observe the efficacy and safety of applying sirolimus-eluting stents in emergency percutaneous coronary intervention （PCI） for the patients with acute myocardial infarction （AMI）. Methods In total, 220 patients with AMI were enrolled in this study at Shanghai Tongji Hospital, divided into two groups, one with bare-metal stent and the other with sirolimus-eluting stent. Cardiovascular fatality, major adverse cardiac events （MACE） and target vessel revascularization （TVR） were observed one and six months after PCI in the two groups. Results There was no significant difference in overall fatality and MACE in the 1 st or 6^th months after PCI between the two groups. Three cardiogenic deaths occurred in bare-metal stent group with a fatality of 2. 8 percent, and five deaths in sirolimus-eluting stent group with a fatality of 4. 5 percent in six months after PCI. However, rate of restenosis in those with sirolimus-eluting stents was significantly lower than that of bare-metal stents （ 6. 0 percent vs 16. 1 percent, P 〈 0. 05 ）. Conclusion Sirolimus-eluting stent is safe and effective in emergency PCI for AMI patients, as compared with bare-metal stents, which can work better in lowering rate of restenosis and improving revascularization after PCI.

关 键 词：心肌梗塞 血管成形术 经腔 经皮冠状动脉 药物洗脱支架 

分 类 号：R541.4[医药卫生—心血管疾病]