国产药物洗脱支架对急性ST段抬高心肌梗死患者的疗效观察

Clinical observation of Firebird Rapamycin eluting stent therapy in acute ST-segment elevation myocardial infarction

目的探讨国产雷帕霉素药物洗脱支架Firebird在急性ST段抬高心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)中应用的安全性和有效性。方法选择STEMI且在发病12h内接受急诊置入Firebird支架的患者96例,记录住院期间、术后9个月时不良心脏事件(MACE)的发生率。结果96处梗死相关病变置入150枚Firebird支架,支架置入成功率为100%,介入治疗后血流TIMI3级86例(89.6%),无复流现象3例,其中术中死亡1例;心脏破裂死亡2例;早期支架内血栓形成2例,其中死亡1例。住院期间MACE发生率为5.2%(5/96),PCI临床成功率为86.5%(83/96)。对82例患者进行了6～24个月的随访,平均(9.6±3.4)个月,因心力衰竭死亡2例,随访时MACE发生率2.4%(2/82)。结论国产雷帕霉素药物洗脱支架Firebird在STEMI急诊PCI中应用安全有效。

Objective To evaluate the efficacy and safety of Firebird drug eluting stent therapy in primary percutaneous coronary intervention （PCI） for acute ST-segment elevation myocardial infarction （STEMI）. Methods From March 2005 to June 2006, a total of 96 patients with acute STEMI received Firebird drug eluting stents within 12 hours after symptoms onset were enrolled in this study. The incidences of major adverse cardiovascular event （MACE） and stent thrombosis were analyzed in hospital and 9 months after discharged. Results One hundred and fifty Firebird stents were implanted in 96 lesions. The procedure success rate was 100% No reflow phenomenon occurred in 3 cases,2 cases died of heart rupture in hospital. Two cases developed acute stent thrombosis and one died. In hospital MACE rate was 5.2% （5/96）, clinical PCI success rate was 86.5% （83/ 96）. Eighty two discharged patients were followed up for 6 to 24 （9.6±3.4） months. 2 patients died of heart failure. The MACE rate during follow up was 8. 1% （7/86）. Conclusions Firebird drug eluting stent implanting in emergency PCI for acute STEMI patients is safe and effective.