68例应用药物洗脱支架介入治疗冠心病远期预后探究.docVIP

68例应用药物洗脱支架介入治疗冠心病远期预后探究【中图分类号】R654.2 【文献标识码】 A【文章编号】1672-3873（2011）03-0115-03 【摘要】目的：评价药物洗脱支架在冠心病介入治疗中的预后。方法：回顾性分析广东省茂名市人民医院心内科2004年11月～2008年12月应用药物洗脱支架的68例冠心病患者，收集l5～52个月的临床资料，评价经皮冠脉介入治疗(PCI)术后临床症状的改善情况；主要心脏不良事件(MACE)。 MACE 包括心源性死亡、非致命性心肌梗死和靶血管重建(TVR)；其中14例复查冠脉造影，对其支架内再狭窄、支架内血栓形成、靶血管动脉瘤的发生率进行统计分析。结果:68例冠心病患者共成功植入药物洗脱支架122枚，PCI术后39例患者临床症状完全缓解，21例患者的临床症状明显改善，临床症状缓解率达88．23％。DES植入术后住院期间MACE发生率为1.5％(1／68)，院外随访期间MACE发生率为4.5％(3／68) 。冠状动脉造影复查发现晚期支架内血栓形成发生率为1.5％(1／68)；支架内再狭窄发生率为5．9％ (4／68)，其中2例再次于靶病变处植入DES。PCI术后应用双联抗血小板药物过程中的出血并发症6例。结论：药物洗脱支架在冠心病介入治疗中应用是安全、有效的，MACE、支架内再狭窄和支架内血栓形成的发生率很低。 【关键词】血管成形术， 经腔，经皮冠状动脉；支架；冠状动脉疾病；血小板聚集抑制剂；心肌梗死 Long-term prognosis study of implanting drug-eluting stents in 68 patients with coronary heart disease Huangwei (Department of Comprehensive，Maoming PeopleS Hospital， Maoming 525000，China) 【Abstract】Objective :Safety of drug-eluting stents has aroused much attention due to increased intra―stent thrombosis，myocardial infarction and death in clinical practices． The goals of our study were to determine the effectiveness and safety of drug―eluting stents in patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention．Methods: A total of 68 CAD patients who underwent drug―eluting stents were retrospectively analyzed in the department of cardiology of Huashan hospital from November 2004 to December 2008．Overall clinical data (15-52 months) were generally obtained to assess the clinical effectiveness and major adverse cardiac events (MACE)including cardiac death，non―fatal myocardial infarction and target vessel revascularization (TVR)． Clinical follow-up in-stent restenosis (ISR)，late intra-stent thrombosis and stent aneurysm of the target vessel were analyzed by coronary angiography again in 14 patients．Results :Of the 68 CAD who were successfully treated with 122 drug―eluting stents by means ofpercutaneous coronary intervention， the symptoms were relieved in 39 patients， and improved in 21 patie