雷帕霉素洗脱支架在急性冠状动脉综合征中的应用

目的 观察雷帕霉素洗脱支架(CypherTM)对急性冠状动脉综合征(acute coronary syndrome,ACS)的疗效.方法 选择住院的接受雷帕霉素洗脱支架植入的ACS 83例,在支架植入术后9个月内,进行电话或门诊随访,冠状动脉造影或冠状动脉螺旋CT扫描,计算不良心脏事件发生率,评价合并糖尿病及其它病变的疗效.结果 83例患者共植入支架112枚,植入成功率为98.8%.接受冠状动脉造影29例(34.9%),接受冠状动脉螺旋计算机断层扫描1例.发生主要不良心脏事件10例,发生率12.0%,其中猝死1例,再发心肌梗死1例,再次血运重建8例(1例为新的病变),与支架相关的再狭窄及血栓事件发生率为10.8%(9/83);糖尿病、弥漫病变、重叠支架、高血脂时再狭窄率分别为13.3%,11.1%,11.1%和8.5%.结论 雷帕霉素洗脱支架治疗ACS安全、可靠;弯曲、弥漫、较长的冠状动脉病变或合并糖尿病者,出现再狭窄的概率增加.

Application of cypherTM drug eluting stent in the treatment of acute coronary syndrome

Objectives To evaluate the efficacy of CypherTM drug eluting stent in the treatment of patients with acute coronary syndrome(ACS).Methods A total 83 acute coronary syndrome patients undergone coronary artery cypherTM drug eluting stenting(DES) received follow up by telephone and angiography or coronary antery super-speed CT to evaluate the rate of major adverse cardiac event(MACE) and the efficacy of with diabetes mellitus(DM) and other complicated lesions during 9 months.Results One hundred-twelve stents were implantation in 83 patients.The success rate of stent implantation was 98.8%( 82/83),29 patients received angiography check,one by super-speed CT.The overall rate of MACE were 12% with 10 patients,including 1 sudden death,1 acute myocardial infarction(AMI),8 lesion revascularization( TLR),The total restenosis rate that connected with DES was 10.8%(9/83),and among it 13.3% was DM patients,11.1% with diffuse lesion and overlapping stent,8.5% with hypercholesterolemia.Conclusions CypherTM is safe and effective in ACS patients,but there are a few rate of restenosis with cross,diffuse lesion,overlapping stent,DM and hypercholesterolemia patients.