雷帕霉素洗脱支架在冠心病患者中应用一年后的疗效

One year effect of rapamycin eluting stent in patients with coronary heart disease

目的 评价雷帕霉素洗脱支架在冠心病患者中应用 1年后疗效。方法 从 2 0 0 1年 12月到 2 0 0 3年 9月共有 14 3例冠心病患者置入Cypher药物支架 173枚 ,16 (9.3% )枚药物支架为直接置入 ,其余 15 7枚 (90 .8% )药物支架在置入前给予球囊预扩张。支架释放压力为 8～ 16atm ,其中 5 2 (30 .1% )例进行了后扩张。所有患者术前、术后给予足量抗血小板药物。结果 手术成功率 99.3% ,138例患者完成随访 ,平均随访时间为 (12 .8± 4 .3)个月。复发心绞痛 13例 (9.4 % ) ,急性心肌梗死 1例 (0 .7% )。 38例(2 7.3% )患者在术后 6～ 12个月内进行了冠脉造影复查。 5例患者为药物支架内出现再狭窄 ,其中 4例给予再次血管成形术 (TLR)。再狭窄率占所有患者的 (3.6 % ) ,占所有造影复查患者的 13.2 %。结论 雷帕霉素洗脱支架 1年后临床应用的效果良好 ,可降低再狭窄的发生 。

Objective To evaluate the long-term results of rapamycin eluting stent in patients with coronary heart disease.Methods From Dec. 2001 to Nov. 2002, 143 patients were treated with 173 rapamycin eluting stents. Sixteen stents were implanted directly, the others were implanted with pre-dilation. Post-dilations were performed in 52 stents. All patients were administered aspirin and clopidogrel regularly before and after the procedures. Results Procedural succees rate reached 99.3% with completion of the follow-up in 138 patientes averaging (12.8 ±4.3) months. Thirteen patients has suffered with recurrent angina and 1 had acute myocardial infarction. Thirty eight patients received repetition of coronary angiography within 6 to 12 months after the procedure. Five patients showed instent restenosis, of which 4 received target lesion revascularization. The restenosis rate was 13.2% by angiography.Conclusion Rapamycin eluting stent can be used safely and effectively in patient with coronary heart disease, having long-term effect to reduce the restenosis rate after PCI.