药物洗脱支架植入术后支架内血栓形成的临床分析  

Clinical Analysis of Stent Thrombosis after Drug-eluting Stent Implantation

作　　者：简斌[1] 杨晓蕾[1] 黄郁[1] 张立国[1] 张有明[1] 喻卓[1] 

机构地区：[1]昆明医科大学第一附属医院心内科,云南昆明650032

出　　处：《昆明医科大学学报》2012年第12期117-120,共4页Journal of Kunming Medical University

基　　金：云南省卫生厅科研基金资助项目(2011WS0029)

摘　　要：目的分析药物洗脱支架内血栓形成的临床相关因素及处理方法.方法选自2009年7月至2012年7月行经皮冠状动脉介入治疗(percutaneous coronary intervention,PC)I的703例冠心病(coronary heart disease,CHD)患者,记录发生药物洗脱支架内血栓形成患者的一般情况、冠脉病变特点、PCI治疗情况及抗血小板药物治疗情况,分析其支架内血栓形成的原因及血栓形成后的处理方法.结果 703例接受药物洗脱支架治疗的CHD患者中,有7例患者共发生了9例次(1.28%),10个靶病变在PCI治疗后20 h～7个月内发生了支架内血栓形成.结论支架内血栓形成可能与以下因素相关:有吸烟、高脂血症、高血压、高尿酸等冠心病高危因素者;多支架植入、支架贴壁不良、混用不同类型的支架、无高压后扩张、长病变、分叉病变等;抗栓治疗不充分等.另外,溶栓及急诊再次介人治疗是支架内血栓形成的有效治疗方法.Objective To study clinica! factors and treatment about thrombosis in drug-eluting stent. Methods A cohort of coronary heart disease patients treated with percutaneous coronary intervention were selected from Jul 2009 to Jul 2012. The clinical data, characteristics of coronary lesion and intervention procedure, as well as antiplatelet therapy of the patients with thrombosis were recorded, and the reasons and treatment of stent thrombosis were analyzed. Results Altogether 703 CHD patients were enrolled into the study. Nine cases （1.28%） of stent thrombosis occurred in 7 patients. 10 target lesions developed stent thrombosis within 20 hours to 7 months after PCI. Conclusions Stent thrombosis probably correlates with the following factors： coronary heart disease risk factors including smoking, hyperlipidemia, hypertension and high uric acid levels, multiple stent implantation, the stent malappositiont, mix different types of stents, without high pressure postdilation, long lesions, bifurcation lesions, and imcomplete treatment of antithrombus. Moreover, thrombolysis and emergency percutaneous coronary intervention is the effective treatment for stent thrombosis.

关 键 词：冠心病 药物洗脱支架 支架内血栓 

分 类 号：R541.4[医药卫生—心血管疾病]