择时冠状动脉内支架治疗不稳定型心绞痛临床效果观察

Clinical effect of coronary artery stent implantation at different time points in the treatment of unstable angina

目的观察早期冠状动脉内支架植入术与延迟支架植入术治疗不稳定型心绞痛的临床效果。方法选择我院收治的80例不稳定型心绞痛患者为研究对象,随机分为对照组和观察组各40例。对照组入院后7-10 d行支架术,观察组入院后48 h内行支架术。比较两组患者的手术成功率、再狭窄发生率及治疗前后冠状静脉窦NO水平变化情况。结果观察组手术成功率（92.5%）明显高于对照组（75.0%）,随访再狭窄发生率（2.5%）明显低于对照组（20.0%）,观察组术后即刻及术后6 h的NO水平分别为（54.2±12.3）μmol/L和（70.5±13.5）μmol/L,均明显低于对照组的（84.6±13.1）μmol/L和（93.6±12.8）μmol/L,以上各项指标比较差异均有统计学意义（P〈0.05）。结论选择早期冠状动脉内支架植入术治疗不稳定型心绞痛成功率高,再狭窄发生率低,治疗后冠状静脉窦NO水平下降显著,值得临床推广应用。

Objective To observe the clinical effect of early coronary artery stent implantation and de- layed coronary artery stent implantation for treatment of unstable angina. Methods Eighty patients of unstable angina in our hospital were selected as the research objects, which were randomly divided into control group and observation group, with 40 patients in each group. The control group received coronary artery stent implantation 7-10 d after admission, while the observation group underwent coronary artery stent implantation in 48 hours after admission. The surgical success rate, incidence of restenosis, and level of NO in coronary sinus before and after treatment were compared between the two groups. Results The surgical success rate in the observation group （92.5%） was significantly higher than that in the control group （75.0%）, and the incidence of restenosis in the ob- servation group was significantly lower （2.5% vs 20.0%）. NO level immediately after surgery （54.2±12.3） μmol/L and postoperative 6 hours （70.5±13.5） μmol/L in the observation group were significantly lower than those in the control group, （84.6±13.1） μmol/L and （93.6±12.8） μmol/L, P〈0.05. Conclusion Early coronary artery stent im- plantation in the treatment of unstable angina results in high success rate, low incidence of restenosis, significantly de- creased NO level in coronary sinus after treatment, which is worthy of clinical popularization and anplication.