直接经皮冠状动脉介入雷帕霉素药物洗脱支架内血栓形成的临床分析

Clinical analysis of rapamycin drug-eluting stent thrombosis after Primary percutaneous coronary intervention

目的探讨ST段抬高性心肌梗死患者直接经皮冠状动脉介入（PCI）雷帕霉素药物洗脱支架后支架内血栓形成的相关因素及预后。方法521例ST段抬高性心肌梗死患者行直接PCI置入雷帕霉素药物洗脱支架，经住院治疗及门诊随访6个月以上，分析12例（13次）患者发生支架内血栓形成的相关因素及预后。结果521例患者支架内血栓形成的发生率2.50％（13／521），6个月内病死率达41.7％（5／12）；7例存活患者出现不同程度左心室舒张末内径扩大和左心室射血分数减低。结论雷帕霉素药物洗脱支架内血栓形成是多因素相关的临床事件，患者病死率高、预后差。

Objective To observe Rapamycin drug-eluting stent thrombosis after primary percutaneous coronary intervention （PCI） for ST-segment elevation myocardial infarction （STEMI）. Methods Primary PCI with implantation of rapamycin drug-eluting stent was performed in 521 patients with STEMI. Among them, 12 cases suffering from stent thrombosis after PCI were observed. Results The incidence of stent thrombosis was 2.5% （ 13/ 521）, the death rate of the 12 cases in 6 months was 41.7% （5/12）. Meanwhile enlarged left ventricular end diastolic diameter and reduced left ventricular ejection fraction occurred in 7 survival patients within 6 months. Conclusion Rapamycin drug-eluting stent thrombosis was a clinical incident with multiple risk factors and related to high mortality and poor prognosis.