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ST段抬高的急性心肌梗死急诊置入药物洗脱支架与普通金属裸支架的比较 (PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2007年第3期
页码:
306-308/314
栏目:
临床研究
出版日期:
2007-06-01

文章信息/Info

Title:
Comparison of Cypher drugeluting stent and Bxsonic bare stent implanted following emergency percutaneous coronary intervention in patients with STsegment elevation acute myocardial infarction
作者:
罗助荣;  盖晓波;  林毅
南京军区福州总医院心内科，福建 福州 350025
Author(s):
LUO Zhurong;  GAI Xiaobo;  LIN Yi
Department of Cardiology, PLA Fuzhou General Hospital, Nanjing Military Area Command, Fuzhou 350025, Fujian,China
关键词:
支架; 药物洗脱; 心肌梗塞; 急性; 急诊冠脉介入; 经皮
Keywords:
stent;  drugeluting;  myocardial infarction;  acute;  emergency coronary intervention ; percutaneous
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 对比观察雷帕霉素药物洗脱支架（Cypher）与普通金属支架（Bxsonic）在急性ST段抬高心肌梗死(STEAMI)急诊冠脉介入（PCI）治疗中应用的安全性和临床疗效。方法 选择我院急诊住院的82例STEAMI患者，在发病时间12 h内急诊行直接PCI治疗，其中50例于梗死相关血管的靶病变植入Cypher支架（Cypher支架组），32例植入Bxsonic支架（普通支架组）。并对其临床资料，病变特征,术后住院期间及随访期间再梗死、死亡、靶血管再成形等心脏不良事件发生率进行分析。结果 两组支架术患者住院期间心脏不良事件发生率无显著差异。平均随访（6.2±2.3）个月，Cypher支架组心绞痛发生率较普通支架组显著减低（5% vs 21%，P<0.01）。Cypher支架组无心脏事件生存率显著高于普通支架组（95% vs 78%，P<0.01）。普通支架组支架内再狭窄率较Cypher支架组高。再梗死、心源性死亡、中风等不良事件发生率无显著差异。结论 雷帕霉素药物洗脱支架与普通支架一样在STEAMI急诊PCI中是安全有效的。
Abstract:
AIM To compare the safety and efficacy of Cypher drugeluting stent and Bxsonic stent implanted after the emergency percutaneous coronary intervention (PCI) in patients with STsegment elevation acute myocardial infarction (STEAMI). METHODS Eightytwo patients with STEMI were treated by emergency PCI within 12 hours, with Cypher drugeluting stent implanted in 50 cases group and Bxsonic stent in 32 cases. The inhospital baseline data and the incidence of major adverse cardiovascular events (MACE) in followup period were evaluated. RESULTS No significant difference was observed in the inhospital cardiac events between the Cypher stent group and the Bxsonic stent group . During the followup period (mean 6.2±2.3 months), the occurrence rates of angina pectoris in the Cypher stent group were lower than those in the Bxsonic stent group（5% vs 21%, P<0.01）. The survival rate without MACE in the Cypher stent group was higher than that in the Bxsonic stent group（95% vs 78%, P<0.01）The instent restenosis rate was lower in the Cypher stent group. But no significant difference was found in the occurrence rate of cardiac events and cardiac death between the groups. CONCLUSION Implantation of Cypher drugeluting stent after the emergency PCI is as safe and effective as the conventional bare stent in patients with STEAMI.

参考文献/References

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［6］ Degertekin M, Serruys PW, Foley DP, et al. Persistent inhibition of neointimal hyperplasia after sirolimuseluting stent implantation: longterm (up to 2 years) clinical,angiographic, and intravascular ultrasoundfollowup［J］. Circulation,2002,106（13）: 1610-1613.

［7］ Moussa I,Leon MB,Baim DS, et al.Impact of sirolimuseluting stents on outcome in diabetic patients:a SIRIUS substudy［J］. Circulation, 2004,109（19）:2273-2278.

［8］ Valgimigli M,Percoco G,Malagutti P, et al. Tirofiban and sirolimuseluting stents vs abciximab and baremetal stent for acute myocardial infarction:a randomized trial［J］. JAMA,2005,293（17）:2109-2117.

［9］ 罗助荣，盖晓波. 延迟性血运重建术对溶栓失败的急性心肌梗死患者近远期预后的影响［J］. 心脏杂志，2004，16（6）：550-552.

备注/Memo

备注/Memo:
收稿日期：2006-03-22.通讯作者：罗助荣，副主任医师主要从事冠心病介入诊断及治疗研究 Email：fzzbing@vip.sina.com.cn
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