冠状动脉支架内血栓的危险因素及防治

Risk factors and prevention of coronary artery stent thrombosis

经皮冠脉介入治疗是冠心病治疗的主要方式之一,冠状动脉支架内血栓虽是少见并发症,多数直接导致急性心肌梗死,病死率高,故应尽量减少造成支架内血栓的影响因素,做到预防为主;掌握支架内血栓的发病机制、影响因素及处理,对临床工作有重要的指导意义。支架内血栓的发病机制复杂,目前尚不完全清楚;其影响因素包括患者临床状况、冠脉病变因素、手术操作因素、支架因素及抗凝、抗血小板药物的使用等多方面。针对患者的发病机制及影响因素等采取积极药物治疗与器械治疗相结合的方式预防及处理支架内血栓至关重要。作者将分别叙述药物洗脱支架内血栓定义、流行病学、发病机制、危险因素、临床表现及支架内血栓预防与处理。

Percutaneous coronary intervention is a main therapy for coronary disease. Although coronary artery stent thrombosis is a rare complication, it may directly result in acute myocardial infarction, with higher fatality rate. Therefore, it is necessary to reduce the risk factors of coronary artery stent thrombosis as far as possible, and implement the prevention first. To know the nosogenesis, influencing factors and treatment of coronary artery stent thrombosis have an important significance to clinical work. The nosogenesis of coronary artery stent thrombosis is complex, which is not entirely clear. The influencing factors include clinical conditions of patients, coronary artery disease, operative procedure, stent factor, and use of anticoagulation and antiplatelet drugs. The combination of medication and apparatus treatment based on the nosogenesis, and influencing factors plays an important role in prevention and treatment of coronary artery stent thrombosis. The authors will describe the definition, epidemiology, nosogenesis, risk factors and clinical manifestation of drug eluting stent thrombosis, as well as the prevention and treatment of coronary artery stent thrombosis.