药物洗脱支架内急性和亚急性血栓形成的风险评估  

Risk Assessment of Acute and Subacute Stent Thrombosis after Drug-eluting Stent Implantation

作　　者：张悦[1] 刘新文[1] 方舟[2] 张蓝宁[2] 张玉霄[2] 卢才义[2] 

机构地区：[1]浙江医院心内科,杭州市310013 [2]中国人民解放军总医院老年心内科

出　　处：《心电与循环》2013年第3期157-160,共4页Journal of Electrocardiology and Circulation

基　　金：浙江省医药卫生科学研究基金资助项目(2009A015)

摘　　要：目的探讨药物洗脱支架（DES）植入后支架内急性和亚急性血栓形成的危险因素。方法回顾性分析2550例行DES植入术的冠心病患者中发生急性和亚急性血栓的患者32例（血栓组），并随机抽取未发生支架内血栓的患者50例（非血栓组）。对两组患者随访9～12个月，比较主要不良事件的发生情况。使用多因素逻辑回归分析法对血栓形成进行风险评估。结果随访期间血栓组的主要不良事件发生率高于非血栓组，差异有显著统计学意义（P〈0．01）。支架植入不良、阿司匹林／氯吡格雷抵抗、高凝状态、低血压、低血容量状态均与急性和亚急性血栓形成相关（均P〈0．05）。结论支架植入不良、阿司匹林／氯吡格雷抵抗、高凝状态、低血压和低血容量状态是DES植入术后患者发生急性和亚急性血栓形成的高危因素。Objective To assess the risk factors for acute and subacute stent thrombosis （ST） formation after drug-eluting stent implantation. Methods 32 cases with acute and subacute ST and 50 cases without ST out of 2550 patients received DES implantation for coronary artery disease were included and major adverse events occurred during follow-up 9-12 months were analyzed retrospectively. Multiple logistic regression analysis was used to assess risk factors of ST. Results The incidence of major adverse events was higher in patients with than without ST during the follow-up period（P〈0.01）. Inappropriate stenting, aspirin or clopidogrel resistance, hypercoagulation, hypotension and hypovolemia were associated with ST formation （all P〈0.05）. Conclusion Inappropriate stenting, aspirin or clopidogrel resistance, hypercoagulation, hypotension and hypovolemia are risk factors of ST formation.

关 键 词：冠状动脉疾病 支架 支架内血栓 

分 类 号：R541.4[医药卫生—心血管疾病]