Cypher~(TM)支架治疗冠心病的疗效观察
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广东省科委科技攻关项目(99B06702G)


Efficacy of Cypher~(TM) Stent in Patient with Coronary Heart Disease
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    摘要:

    目的评价雷帕霉素洗脱冠状动脉支架(CypherTM)应用于冠心病的临床疗效及再狭窄情况。方法选择接受CypherTM支架治疗的348例冠心病患者,观察术后即刻效果、术后6个月心脏性死亡、心肌梗死、再次血管重建及冠状动脉造影复查情况。病例中包括ST段抬高的急性心肌梗死86例,非ST段抬高的急性心肌梗死21例,不稳定型心绞痛149例,稳定型心绞痛92例。结果支架植入成功率99.3%,住院期间无死亡,术后出现急性和亚急性血栓各1例,1例晚期血栓致心肌梗死,1例心衰死亡,另有5例随访中进行了血管重建术,术后6个月主要心脏不良事件发生率2.9%。术后6个月56例冠状动脉造影复查的再狭窄率为7.1%(支架内为1.8%),支架内平均晚期管腔丢失为0.16mm(病变段内为0.20mm),靶病变重建率为5.4%。结论应用CypherTM支架治疗冠心病是安全和有效的,主要心脏不良事件发生率低,支架内再狭窄率和靶病变重建率明显低于普通金属支架。

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    Aim To investigate the effect and security of Cypher~ TM stent (sirolimus-eluting stent) in patients with coronary heart disease (CHD). Methods 348 CHD cases were treated with 436 Cypher~ TM stents. Among the 348 patients, 86 had ST-segment elevation acute myocardial infarction (AMI), 21 had non-ST-segment elevation AMI, 149 had unstable angina and 92 had stable angina. As for lesion characteristics, diffuse disease was found in 88 cases (25.3%), bifurcation lesions in 62 cases (17.8%), chronic total occlusion lesions in 55 cases (15.8%), in-stent restenosis in 15 cases. The immediate angiographic outcome, six months follow-up results with major cardiac event (MACE) and angiographic follow-up at 6 months had been assessed. Results A successful stenting procedure was achieved in 99.3% patients with CHD. Acute and sub-acute stent thrombosis occurred in 2 patients, late stent thrombosis with AMI occurred in 1 patient. There was 1 case death during the 6 months follow-up. The MACE rate during hospitalization was 0.6% and during 6 months follow-up was 2.9%. Angiographic follow-up at 6 months showed that in-stent restenosis rate (ISR) was 7.1% (restenosis within the stents was 1.8%), the late loss in lesion was 0.16 mm (in-stent was 0.20 mm). The target vessel revascularization (TLR) rate was 5.4%. Conclusion Cypher~ TM stent implantation in CHD is safe and effective, and the ISR rate and TLR rate are significantly lower than that of bare metal stents.

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胡承恒,杜志民,罗初凡,李怡,伍贵富,曾武涛,吴杏. Cypher~(TM)支架治疗冠心病的疗效观察[J].中国动脉硬化杂志,2006,14(3):230~232.

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  • 收稿日期:2005-04-21
  • 最后修改日期:2006-02-10
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