冠状动脉内支架植入术联合应用阿昔单抗对急性冠状动脉综合征治疗的临床观察

目的评价冠状动脉(以下简称冠脉)内支架植入术联合应用阿昔单抗在急性冠脉综合征(AC6)治疗中的可行性、安全性及疗效,探讨介入治疗的最佳方案.方法对607例ACS患者行经皮穿刺冠状动脉介入治疗(PCI),其中223例(支架加阿昔单抗组)冠脉造影显示冠脉血管中有血栓形成者给予冠脉内支架置入术,同时静脉应用阿昔单抗;384例(单纯支架组)行单纯冠脉内支架置入术.对随访结果进行分析和总结.结果在平均10.6个月的随访期中,两组患者均未发生脑血管意外.发生急性心肌梗死6例,其中单纯支架组5例(1.30%),显著高于支架加阿昔单抗组的1例(0.44%);再次血运重建85例,单纯支架组71例(18.48%),支架加阿昔单抗组14例(6.28%).结论机械性再灌注策略和阿昔单抗合用安全有效,可降低ACS患者PCI术后缺血、心脏事件的发生率,改善患者预后.

Clinical evaluation of coronary stent implanatation with abciximab in acute coronary syndromes

Objective To investigate the safety and feasibility of using abciximab during percutaneous tranluminal coronary angioplasty (PTCA) and to explore a suitable strategy for invasive therapy in acute coronary syndromes (ACS). Methods 607 patients with ACS had received percutaneous coronary intervention (PCI) including 223 cases who were reported to have thrombus in coronary were assigned to receive abciximab (intravenous) meanwhile. Baseline clinical characteristics, interventional procedures, occurrence of major adverse cardiac events more than 10 months during follow-up were compared. Results During follow-up (average 10.6months),there was no cerebral vascular accident in both groups; the revascularization occurred in 19% (71 patients)in stenting group (5 infarction ), however, those who had received stenting with abciximab had a lower rate (6.28%, 14 patients) of revascularization (1 infarction). Conclusions The application of abciximab with stent implantation is safe and feasible in patients with ACS. Abciximab can reduce the incidence of ischemic complications and MACE of stenting alone in patients with ACS can improve the outcomes.