药物涂层支架在老年冠状动脉相关疾病治疗中的应用及评价

Application and evaluation of drug-eluting stent in treatment of elderly coronary artery-associated diseases

背景:药物涂层支架由于显著降低了冠脉内支架置入再狭窄的问题,使其应用范围不断扩大。目的:从材料学及临床应用方面阐述如何提高老年心血管疾病中药物涂层支架的相容性。方法:以"药物涂成;心血管支架;生物相容性;老年;介入"为中文关键词;采用计算机检索1995-01/2010-10万方数据库及中国知网数据库相关文章。纳入与老年心血管疾病介入治疗中药物涂层的相关文章;排除重复研究或Meta分析类文章。以25篇文献为主重点分析了药物涂层支架在老年心血管疾病介入治疗中相容性。结果与结论:老年冠状动脉粥样硬化性心脏病患者正日益增多,支架置入治疗疗效及应用价值在此领域已经得到循证医学的验证,但由于老年患者的年龄、身心状况等问题,以及长期置入支架后会导致血栓、动脉瘤、支架移位等并发症,所以老年患者置入支架的安全性及生物相容性有较高的要求。药物涂层支架的出现,将心血管介入治疗手段与局部缓释技术完美结合起来,大幅减低传统支架血管再狭窄概率,提高了置入后的生物相容性,为老年心血管疾病带来很好的治疗前景。

BACKGROUND： Drug-eluting stent significantly reduced the restenosis of stent implantation in the coronary artery, and its application became extensive. OBJECTIVE： To investigate how to elevate the compatibility of drug-eluting stent in elderly cardiovascular disease from aspects of material and clinical application. METHODS： The key words were ＂drug eluting, cardiovascular stent, biocompatibility, elderly, intervention＂. We retrieved Wanfang Database and China National Knowledge Infrastructure from January 1995 to October 2010. Articles concerning drug-eluting stent in elderly cardiovascular disease were included. Articles of repetitive study or Meta analysis were excluded. Using 25 articles, we analyzed the compatibility of drug-eluting stent in elderly cardiovascular diseases. RESULTS AND CONCLUSION： Elderly patients with coronary atherosclerotic heart disease became more and more. The therapeutic effect and application of stent implantation have been verified by evidence-based medicine. However, because of the age and physical and mental conditions of elderly patients, stent implantation-induced thrombus, aneurysm and stent displacement, the safety and biocompatibility of stent implantation in elderly patients should be high. The appearance of drug-eluting stent perfectly combined cardiovascular intervention and local slow release, greatly reduced the rate of vascular restenosis of traditional stent, elevated biocompatibility after stent implantation, and brought good perspective for elderly cardiovascular disease.