药物涂层支架的前景及展望

Perspective and prospect of drug-eluting stents

目的:根据近年冠状动脉支架治疗冠状动脉硬化性心脏病的近况,认识药物涂层支架在心肌梗死治疗的最新研究与应用情况。资料来源:应用计算机检索PubMed2000-01/2006-04相关药物涂层支架的文献,检索词“drug-elutingstents,coronaryheartdisease”,并限定文献语言种类为英语。资料选择:对资料进行初审,选取包括药物涂层支架的相关文献,开始查找全文。纳入标准:药物支架治疗冠状动脉硬化性心脏病。排除标准:重复研究,综述文献,Meta分析类文章。资料提炼:纳入30篇符合标准的文献进行探讨。资料综合:药物涂层支架是将药物直接或者通过适当的载体涂布于支架表面,使支架成为一个局部药物释放系统,既可以增加治疗药物的局部浓度及作用时间,又可以避免全身用药带来的毒副作用。目前常用的支架为雷帕霉素涂层支架,紫杉醇支架,Driver支架等。它们都很好的减少了再狭窄,以至目前介入治疗的90%～95%都包括了支架植入术。结论:药物涂层支架是介入心脏病学的一项重要突破,使介入心脏病学进入了一个新的时代。

OBJECTIVE： According to the state that coronary-artery stents in treating coronary heart disease in recent years, to recognize the latest research and application of drug-eluting stents in treating myocardial infarction. DATA SOURCES ： We searched the PubMed database for articles on drug-eluting stents published in English from January 2000 to April 2006 with the key words of ＂drug-eluting stents, coronary heart disease＂. STUDY SELECTION： The literatures about drug-eluting stents wore collected primarily, and then the full-texts wore retrieved. Inclusive criteria： articles on drug-eluting stents in treating coronary heart disease. Exclusive criteria： repetitive, review and Meta analysis articles. DATA EXTRACTION： Totally 30 articles were selected for analysis. DATA SYNTHESIS： Drug-eluting stents are local drug delivery systems, in which the drug is spread directly or by proper carder on the surface of stents to increase local concentration of the drug and active time and reduce the rate of stent thrombosis. At present, the widely used stents are Sirolimus-Eluting stents, Polymeric PaclitaxeI-Eluting stents, Driver stents and so on. They have changed percutaneous coronary intervention, so that 90% to 95% treatment involves stent implantation. CONCLUSION： Drug-eluting stents is an important breakthrough in interventional cardiology, which leads the interventional cardiology to a new generation.