Cypher雷帕霉素药物洗脱支架在急性ST段抬高心肌梗死中的临床观察

目的:观察Cypher雷帕霉素药物洗脱支架在急性ST段抬高心肌梗死(ASTEMI)中的临床研究.方法:入选2003年10月至2005年6月确诊ASTEMI患者76例行急诊冠脉造影和PCI,冠脉造影后明确病变,然后行PTCA及支架置入.在PCI过程中置入Cypher西罗莫司药物洗脱支架.观察术中、住院、出院后有无严重心脏不良事件(包括死亡、非致命急性心肌梗死、靶病变靶血管重建率、再次入院).结果:所有患者均经桡动脉行介入治疗,冠脉造影和支架的成功率为100%.共置入Cypher支架86枚,置入1个支架的患者为66例,置入2个支架的为10例.在支架长度中,支架≥28mm的有38枚支架,＜28mm的有48枚支架.在支架直径中,支架≥3.0mm的有76枚支架,＜3.0mm的有10个支架.放入支架后梗死相关血管前向血流达TIMI3级的有69例,发生无复流的有3例,它们在术中、术后均应用Tirofiban.3例患者(3.9%)在住院期间发生不良事件.1个月随访发现1例三支血管病变患者在出院后1周猝死.出院后4～6个月以上随访有4例患者出现心绞痛入院行冠脉造影.其余患者无不适症状等.共有11例患者(14.4%)在支架术后4～7个月复查冠脉造影,再狭窄率为0%.4例出现心绞痛患者造影发现其它血管狭窄(既往存在)而行支架.结论:Cypher雷帕霉素药物洗脱支架在ASTEMI中的应用是安全和有效的,明显减少再狭窄率.

The Clinical Investigation of Cypher Drug-eluting Stent in Patients with Acute ST-Segment Elevation Myocardial Infarction

Objective: To investigate the clinical study of cypher drug-eluting stent in patients with acute ST- segment elevation myocardial infarction. Methods: 76 patients with STEMI were included from Oct 2003 to June 2005. They were received emergency angiography and cypher drug-eluting stent within 12 hours from the beginning of the heart attack. The MACE were investigated during hospitalization and discharge.Results: Radial puncture was successful in all patients. The success rate for CAG and PCI were 100% , respectively. 86 stents were planted. TIMI3 in IRA reached in 69 patients after stent. Noreflow occurred in 3 patients who received tirofiban. 3 MACE were found during hospitalization. 1 patient died in one week later. Follow-up angiography was performed in 11 patients(14.4% ) . Patients treated with Cypher stents had a lower angiographic restenosis rate which was 0. Conclusion: Implanting of cypher drug-eluting stent was safe and feasible in patients with acute ST-segment elevation myocardial infarction. It can decreased the restenosis.