顽固性不稳定性心绞痛的介入治疗

目的　探讨介入治疗顽固性不稳定性心绞痛的近、远期疗效。方法　回顾性分析连续 48例顽固性不稳定性心绞痛患者 ,入院后 (5 .2± 3.4)d介入治疗患者的临床资料。抗血栓治疗为 :阿司匹林、噻氯匹啶、皮下注射低分子量肝素。 48例患者中 ,有 46例 (95 .8% )植入支架。结果　介入治疗的病例、病变成功率分别为 95 .8% (4 6 48)和93.8% (75 80 )。无 1例发生死亡、急性心肌梗死、急诊冠状动脉旁路移植术。 46例介入治疗均获成功 ,心绞痛完全消失或明显缓解。随诊 2～ 2 4(12 .5± 8.0 )个月 ,8例 (17.4% )发生心脏事件 ,其中 2例 (4 .3% )发生心肌梗死 ,6例(13.0 % )再次行血管重建治疗 (介入治疗 5例 ,冠状动脉旁路移植术 1例 )。结论　在使用阿司匹林、噻氯匹啶、皮下注射低分子量肝素抗血栓疗法和广泛应用支架的前提下 ,介入治疗顽固性不稳定性心绞痛成功率高 ,近期疗效明显 ,远期疗效满意

Percutaneous coronary angioplasty for the treatment of refractory unstable angina pectoris

Objective To assess the short and long term efficacy of percutaneous coronary angioplasty (PCI) with use of stenting and a new anti thrombotic regimen in the treatment of refractory unstable angina pectoris in recent years.Methods Forty eight consecutive patients with refractory unstable angina pectoris treated with PCI (5.2±3.4 days after admission) were retrospectively analyzed.All patients were treated with a new anti thrombotic regimen including aspirin,ticlopidine,and low molecular weight heparin.Forty six (95.8%) of 48 PCIs underwent coronary stenting.Results The success rates for patients and lesions were 95.8% and 93.8%, respectively.No serious complications (death,myocardial infarction,and emergency bypass surgery) occurred.Chest pain disappeared or significantly reduced in all 46 successfully treated patients.During 12.5± 8.0 month follow up,no patient died,2(4.3%) developed myocardial infarction,6(13.0%) underwent target vessel revascularization (repeated angioplasty,5;bypass surgery,1).Conclusion With widespread use of stenting and aspirin ticlopidine fractionated heparin regimen,refractory angina pectoris patients can undergo PCI with high success rate,excellent immediate efficacy,and satisfactory long term efficacy.