经皮腔内冠状动脉成形并支架置入后血管再狭窄的预防及治疗  

Prevention and treatment of vascular restenosis following percutaneous transluminal coronary angioplasty combined with coronary stenting

作　　者：徐铁民[1] 徐梅[2] 

机构地区：[1]唐山职业技术学院,河北省唐山市063004 [2]唐山市协和医院,河北省唐山市063000

出　　处：《中国组织工程研究与临床康复》2009年第22期4317-4320,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：经皮腔内冠状动脉成形加支架置入自1977年应用于临床近来得到了迅速发展,目前广泛应用于治疗急性心肌梗死,但是金属支架可导致血栓形成。近年来携带并释放抑制平滑肌细胞增生药物的洗脱支架已应用于临床,可抑制新生内膜增长,降低再狭窄率。药物洗脱支架置入后延迟晚发血栓形成是近年来引起关注的关键问题,所以支架置入后要给予强有力的抗凝治疗。氯吡格雷与噻氯匹定都是有效的抗血小板药物,与噻氯匹定相比,氯吡格雷不良反应小,安全系数更大,起效也更快。联合应用氯吡格雷加阿司匹林预防及治疗经皮腔内冠状动脉成形术加支架置入后再狭窄是安全有效的。随着导管的改进及相关新技术和新疗法的应用,经皮腔内冠状动脉成形术加支架置入的安全性将进一步提高,从而降低再狭窄率。The percutaneous transtuminal coronary angioplasty combined with coronary stenting has developed rapidly since it applied to clinical in treating acute myocardial infarction in 1977. However, the traditional metal stent would result in thrombosis. The clinic used drug-eluting stent, which carry and release drugs to inhibit contractile fiber cells proliferation, can decrease the restenosis rate by suppressing arterial endothelium growth. The key problem is how to deal with delayed thrombogenesis after drug-eluting stent implantation, therefore, anticoagulant therapy is necessary. Clepidogrel and ticlopidine are main antiplatelet agents; however, compared to ticlopidine, clopidogrel is characterized by less adverse effect, higher safety factor and fast taking effect. Accordingly, it is effective and safe to united application of clopidogrel and aspirin in treating thrombosis after percutaneous transluminal coronary angioplasty combined coronary stenting. And the safety will be improved with the development of technique.

关 键 词：支架置入 经皮腔内冠状动脉成形术 药物洗脱支架 氯吡格雷 

分 类 号：R394.2[医药卫生—医学遗传学]