雷帕霉素洗脱Cypher支架和裸支架治疗老年急性心肌梗塞患者的疗效评价

目的：探讨在老年急性心肌梗塞（AMI）急诊经皮冠状动脉介入治疗（PCI）中植入雷帕霉素药物洗脱支架（CypherTM）及普通裸支架对C反应蛋白（CRP）及预后的影响。 方法：45例老年急性AMI患者，分为CypherTM支架组（n=23）和裸支架组（n=22），所有患者在术前、术后6 h、术后1 d、术后7 d、术后1个月测定CRP，临床随访造影及主要心血管事件。 结果：Cypher^TM支架组23例患者共植入27枚支架，术后TIMI血流3级23例，成功率100%；22例接受随访，随访时间3～11个月，无支架内再狭窄及心血管事件等发生。裸支架组22例患者共植入支架26枚，术后TIMI血流3级21例，临床成功率为95.5%；20例接受随访，随访时间5～13个月，2例患者发生支架内再狭窄（再狭窄率9.09%）。1例猝死，2例新生 血管病变。两组术后6 h、术后1 d CRP水平与术前相比明显增高(Ｐ<0.05)。两组之间比较差异无显著性。结论：应用Cypher^TM支架治疗老年AMI近期安全有效。

Clinic efficacy of CypherTM stent and bare stent in elderly patients with acute myocardial infarction

Objective To investigate the effects of rapamycin eluting stent(Cypher~(TM)) and metal bare stent on the prognosis and C-reactive protein(CRP) in elderly patients with acute myocardial infarction(AMI).(Methods The) immediate angiographic and clinic follow-up outcomes of 45 elderly patients with AMI reciving Cypher~(TM) and bare stent were retrospectively analyzed.CRP levels in Cypher~(TM) and bare stent groups were determined before implantation,6 h,1 d,7 d and 30 d after implantation.Clinical follow-up and major coronary events analysis were developed after operation.Results 27 rapamycin eluting stents were implanted in patients of Cypher~(TM) group and(26 bare) stents were implanted in patients of bare stent group.The Cypher~(TM) stents were successfully implanted with 100%.In patients of Cypher~(TM) group,no serious complications were found in the term of operation and in hospital.There was no restenosis,revascularization and events.In patients of bare stent group,except for(1 patients) with sudden death,angina pectoris occurred in 2 patients,repeat angiography showed that there were new lesions in other coronary arteries of these patients.Restenosis attacked in 2 patients.The concentrations of CRP in Cypher~(TM) and bare stent groups 6 h and 7 d after operation were much higher than that of(pre-operation (P<0.05)).Conclusion Repamycin eluting stent(Cypher~(TM))shows a safety profile and potential efficacy in the treatment of elderly patients with AMI.