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老年糖尿病患者冠脉支架内亚急性血栓的形成与对策
引用本文:李芝峰,廖雪梅,何菲,黄桂梅. 老年糖尿病患者冠脉支架内亚急性血栓的形成与对策[J]. 江苏临床医学杂志, 2013, 0(23): 5-7
作者姓名:李芝峰  廖雪梅  何菲  黄桂梅
作者单位:[1]重庆医科大学附属永川医院心内科重庆,402160 [2]重庆市荣昌县人民医院心内科重庆荣昌,402460
摘    要:
目的评价和探讨老年糖尿病患者冠脉支架术后支架内亚急性血栓(SAT)的发生机制和对策。方法回顾性分析2010年11月-2012年11月本院3例老年糖尿病患者支架植入术后发生SAT的临床特点和发生机制。结果在166例60岁以上和/或糖尿病植入冠脉支架患者中3例(1.79%)发生SAT,1例冠脉造影证实SAT,予以冠脉内球囊扩张及溶栓,完全恢复再灌注;1例为可能sAT;另1例为不排除的SAT。3例患者中2例表现为ST段抬高型心肌梗死,不排除SAT的1例患者猝死。结论支架内SAT可能与C型病变、老年和/或糖尿病、CTO等因素所致术中支架贴壁不良及术后不规范用药有关。

关 键 词:老年糖尿病  冠状动脉支架  血栓形成

Mechanism and countermeasures of subacute thrombosis of intracoronary stent in elderly diabetic patients
LI Zhifeng,LIAO Xuemei,HE Fei,HUANG Guimei. Mechanism and countermeasures of subacute thrombosis of intracoronary stent in elderly diabetic patients[J]. Journal of Jiangsu Clinical Medicine, 2013, 0(23): 5-7
Authors:LI Zhifeng  LIAO Xuemei  HE Fei  HUANG Guimei
Affiliation:1. Department of Cardiology, Yongchuang Hospital Affiliated to Chongqing Medical University, Chongqing , 402160; 2. Department of Cardiology, Rtmgchang People's Hospital, Rongchang , Chongqing , 402460)
Abstract:
Objective To explore the mechanism and countermeasures of subacute thrombo- sis (SAT) of intracoronary stent in elderly diabetic patients. Methods Clinical features and mecha- nism of SAT in 3 elderly diabetic patients with coronary stent implantation from November 2010 to November 2012 were analyzed retrospectively. Results Among 166 elderly patients with coronary stent implantation, 3 patients had SAT, the incidence rate of SAT was 1.79%. Among 3 patients with SAT, one patient was diagnosed by coronary angiography and was treated with coronary angio- plasty and thrombolysis, and reperfusion was fully restored; one patient was diagnosed as possible SAT, and one patient was diagnosed as non- exclusive SAT. Manifestation of SAT was ST eleva- tion myocardial infarction in 2 cases, and sudden death was observed in patient with non- exclusive SAT. Conclusion Occurrence of SAT in coronary stent may be related to type C lesion, the elderly or diabetes, adverse intraoperative stent adhesion and discontinued anti - coagulant therapy after PCI.
Keywords:elderly patients  diabetes  coronary stent  thrombosis
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