摘要
目的评价和探讨支架内亚急性血栓(SAT)的发生机制和预防。方法随访和分析2004-2007年5例冠心病患者支架置入术后发生SAT患者的临床和冠脉造影特点。结果(1)在529例冠心病支架置入患者中有5例(0.94%)发生SAT,多于术后2～5d出现。其中3例冠脉造影证实SAT,积极治疗后6个月冠脉造影随访支架内无再狭窄;2例可能为SAT;死亡2例,1例在院外死亡,均为未及时介入治疗。(2)上述5例患者中3例表现为ST抬高型心肌梗死,1例表现为急性左心衰,心源性休克,1例表现为不稳定性心绞痛。4例患者为药物洗脱支架后SAT,1例为裸支架后SAT。结论支架内SAT可能与C型病变,术中支架贴壁不良,急性心肌梗死有关,及时介入治疗可以减少不良后果的发生。
Objective To study the pathogenesis and prevention of subacute thrombosis （SAT） in coronary stents after percutaneous coronary intervention. Methods We reviewed 529 patients who underwent percutaneous coronary intervention （PCI） from January 2004 to August 2007. Among them,5 patients represented SAT associated with coronary stents. The clinical data and angiography results and anti-thrombus treatment of these 5 patients were analyzed. Results （1） The incidence of SAT was 0.94% （5/529）,and it mostly presented at 2-5 d after PCI. Three patients had definite stent thrombosis,and coronary angiography showed no stent restenosis after active treatment for 6 months. Two patients had probable stent thrombosis. Two patients died,one in hospital and one after discharge,both due to absence of timely intervention therapy. （2） Among 5 SAT cases,3 patients represented ST-elevation myocardial infarction,1 represented acute left heart failure and cardiogenic shock,1 represented unstable angina. Four patients represented SAT associated with use of drug-eluting stent,and 1 represented SAT associated with use of bare stents. Conclusion SAT may be related to intraoperative stent malposition,acute myocardial infarction,diabetes and C-type diseases. Timely intervention therapy can reduce the hazard for SAT.
出处
《中华老年多器官疾病杂志》
2010年第1期34-37,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
