紫杉醇洗脱支架治疗冠状动脉硬化性心脏病近期效果

目的评价紫杉醇洗脱支架（PES,商品名TAXUS）治疗冠状动脉硬化性心脏病患者的近期效果及安全性.方法对2003年7月至2004年11月在我院接受PES植入治疗的300例患者的即刻疗效和随访结果进行总结与分析.结果300例患者共处理350处病变,植入支架355枚,其中B2型以上复杂病变248处（70.9%）,小管径支架（2.50～2.75 mm）94处（26.5%）、长支架（＞20 mm）130处（36.6%）;术中未发生严重并发症,手术成功率100%.随访250例（83.3%）,平均随访6个月（1～15个月）,8例（2.7%）患者有心绞痛样发作,其中2例冠状动脉造影复查无支架再狭窄病变,1例于术后5个月发生心肌梗死,2例因非心源性因素死亡.结论PES治疗冠状动脉硬化性心脏病近期效果明显,且较为安全.

Short-term effect of paclitaxel-eluting stent in the treatment of coronary heart disease due to coronary arteriosclerosis

OBJECTIVE: To evaluate the short-term safety and efficacy of paclitaxel-eluting stent (TAXUS stent, Boston Scientific) in the treatment of coronary heart disease (CHD) due to coronary arteriosclerosis. METHODS: From July 2003 to November 2004, 300 consecutive patients with CHD due to coronary arteriosclerosis were admitted for selective percutaneous coronary intervention (PCI) and paclitaxel-eluting stent implantation in the coronary arteries. The immediate effects after PCI and follow-up results were investigated. RESULTS: Altogether 350 lesions were treated and 355 paclitaxel-eluting stents implanted in the 300 cases. Of these lesions, 248 (70.9%) was complicated lesions of B2 type or worse, 94 (26.5%) small-caliber stents (2.50-2.75 mm) and 130 (36.6%) long stents (>20 mm) were implanted, without occurrence of severe intra-operative complications. Follow-up study of 250 cases (83.3%) lasting for 1 to 15 months was conducted, and chest pain was reported in 8 cases, 2 of which underwent coronary artery angiography and no in-stent restenosis was found. One patient developed myocardial infarction 5 months after PCI, and 2 died for non-cardiogenic factors. CONCLUSION: Paclitaxel-eluting stent implantation in patients undergoing PCI is safe approach with good short-term efficacy.