我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

华法林预防冠脉支架术后78例血栓形成的疗效

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第2期
页码:
244-245,248
栏目:
临床研究
出版日期:
2010-03-04

文章信息/Info

Title:
Clinical effects of warfarin on prevention of stent thrombosis after percutaneous coronary intervention
作者:
陈士良; 武效宏; 王小冬; 张金萍; 杨杰
解放军第305医院心内科 全军冠心病诊治中心 北京100017
Author(s):
CHEN Shi-liang;  WU Xiao-hong;  WANG Xiao-dong;  ZHANG Jin-ping;  YANG Jie
Department of Cardiology, PLA 305 Hospital, Beijing 100017, China
关键词:
冠状动脉支架术; 血栓; 华法林; 再狭窄; 出血
Keywords:
percutaneous coronary intervention;  thrombosis;  warfarin;  in-stent restenosis;  hemorrhage
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的: 观察华法林预防冠脉支架术后血栓形成的有效性和安全性。方法: 冠脉支架术后患者78例分为2组，金属裸支架组和药物涂层支架组。在常规治疗的基础上，调整华法林剂量，使INR值保持在2.0左右，观察早期和晚期支架术后患者心绞痛、心肌梗死等临床急性事件的发生及出血并发症。结果: 使用华法林后，两组早期未见临床急性事件出现，也未见出血并发症，晚期出现心绞痛两组分别为3例与1例，未发生心肌梗死事件和出血。对4例心绞痛患者再次行冠脉造影显示，置入支架处未见血栓及再狭窄，而是其他血管和血管段出现了冠脉狭窄。结论: 华法林可防止冠脉支架术后血管形成的急性事件，无论是金属裸支架或药物支架，只要剂量适当，这种作用是安全有效的。
Abstract:
AIM: To observe the clinical safety and effectiveness of warfarin on the prevention of stent thrombosis after percutaneous coronary intervention (PCI). METHODS: Of the 78 patients who were treated with stents, 48 patients with bare-metal stents were enrolled in group A and 30 patients with drug-eluting stents in group B. The clinical manifestations of the two groups were similar. All patients received routine treatment and adjusted dose of warfarin (international normalized ratio 1.5-2.0). We observed and compared the effect of warfarin on acute cardiac events and complications during and after the first month. RESULTS: During the first month, no occurrences of angina and acute myocardial infarction were seen in all the patients, and there were no hemorrhagic complications. After the first month, one case of angina was observed in group A and three cases in group B, but no acute myocardial infarction was seen in either group A or group B. Stenosis was observed in other coronary arteries, but no thrombosis and in-stent restenosis were found at stents. CONCLUSION: Warfarin may prevent acute cardiac event after PCI. With proper dosage, this medication is safe and effective for both bare-metal stents and drug-eluting stents.

参考文献/References

［1］ Honda Y. Stent thrombosis an issue revisited in a changing world［J］. Circulation, 2003, 108(1):2-5.

［2］ 韩亚玲，梁明，荆全民,等. 52例冠状动脉支架内血栓形成患者的临床特点及介入治疗［J］. 中华心血管病杂志, 2006， 34(11):975－978.

［3］ 郭志福，郑兴，秦永文. 药物洗脱支架时代的一个重要问题: 氯吡咯雷抵抗［J］. 中华心血管病杂志, 2006, 34(4)：378-380.

［4］ Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke. EAFT (European Atrial Fibrillation Trial) Study Group［J］. Lancet, 1993, 342(8882):1255-1262.

［5］ 刘长红，刘毅, 赵树武. 药物支架晚期血栓［J］. 心血管病学进展, 2007, 28(3):375-377.

［6］ 李家一. 抗血小板与抗凝药在冠状动脉内支架植入术后的应用［J］. 心血管病学进展, 2000, 21(5):285-289.

［7］ 胡大一，张鹤萍，孙艺红,等. 华法林与阿司匹林预防非瓣膜性心房颤动患者血栓栓塞的随机对照研究［J］. 中华心血管病杂志, 2006, 34(4):295－298.

［8］ 周平, 李法琦. 常用抗血小板和抗凝药物在心脑血管疾病中的应用［J］. 心血管病学进展, 2004， 25(5)：338-341.

备注/Memo

备注/Memo:
收稿日期：2008-7-21.基金项目：全军医药卫生科研课题资助(06MA366) 通讯作者：陈士良，主任医师，主要从事冠心病研究Email:xiaohongwu501@sina.com
更新日期/Last Update: 2010-03-05