摘要
目的探讨雷帕霉素药物洗脱支架在急性心肌梗死急诊PCI术中的临床应用价值。方法回顾性分析近3年行急性心肌梗死急诊PCI术的82例患者临床资料,根据其术中支架使用类型分为雷帕霉素药物洗脱支架组(A组)和普通支架(B组)两组,各41例。比对两组患者冠状动脉血流TIMI分级情况及心肌染色Blush分级情况,行为期6个月随访,记录其死亡率及不良心脏事件发生率。结果 1治疗后,两组患者TIMI分级及Blush分级情况对比无统计学意义(P>0.05);2在术后随访的6个月中,A组死亡1例,B组死亡2例,死亡率分别为2.4%和4.9%,对比无统计学意义(P>0.05);A组支架内再狭窄率为0.0%,明显低于B组的9.8%,两组于随访期内,除支架内再狭窄发生率对比差异明显(P<0.05)外,靶血管重建发生率、心血管事件发生率及支架内血栓率等对比均无统计学意义(P>0.05)。结论对行急诊PCI术的急性心肌梗死患者使用雷帕霉素药物洗脱支架,可有效改善其冠状动脉血流动力学状况,利于其降低支架内再狭窄发生风险,值得临床推广。
Objective To investigate the clinical application of sirolimus - eluting stent in emergency PCI on patients with acute myocardial infarction. Methods Clinical data of 82 cases with acute myocardial infarction underwent emer- gency PCI of the recent 3 years were retrospectively analyzed. They were divided into sirolimus - eluting stent group （group A） and standard stent group （group B）, 41 cases in each group. Compare the TIMI flow grade of coronary artery blood flow and myocardial blush grade, and recorded the death rate and adverse event rate after 6 months＇ follow up. Results ①After treatment, the difference of TIMI flow grade and blush grade of the two groups was not statistically sig- nificant （P 〉 0. 05 ）. ② Of the 6 months follow up, 1 died of group A and 2 died of group B. The death rate were 2.4% and 4. 9% and the difference was not statistically significant （P 〉 0. 05）. The ratio of in - stent restenosis of group A was 0. 0%, obviously lower than group B （9. 8% ）. Over the follow up period, besides the obvious difference of in- stent restenosis （P〈 0. 05 ）, the difference of target vessel revascularization rate, cardiovascular events rate and stent thrombosis rate were not statistically significant （ P 〉 0. 05 ）. Conclusion The application of sirolimus - eluting stent in emergency PCI on patients with acute myocardial infarction can improve the coronary artery hemodynamic envi- ronment and lower the in - stentrestenosis occurrence risk, it was worthy of clinic application.
出处
《医药论坛杂志》
2015年第11期23-24,27,共3页
Journal of Medical Forum
