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目的:观察Cypher雷帕霉素药物洗脱支架在急性ST段抬高心肌梗死(ASTEMI)中的临床研究.方法:入选2003年10月至2005年6月确诊ASTEMI患者76例行急诊冠脉造影和PCI,冠脉造影后明确病变,然后行PTCA及支架置人.在PCI过程中置入Cypher西罗莫司药物洗脱支架.观察术中、住院、出院后有无严重心脏不良事件(包括死亡、非致命急性心肌梗死、靶病变靶血管重建率、再次入院).结果:所有患者均经桡动脉行介入治疗,冠脉造影和支架的成功率为100%.共置人Cypher支架86枚,置人1个支架的患者为66例,置入2个支架的为10例.在支架长度中,支架_28mm的有38枚支架,<28mm的有48枚支架.在支架直径中,支架_3.0mm的有76枚支架,<3.0mm的有10个支架.放入支架后梗死相关血管前向血流达TIMI3级的有69例,发生无复流的有3例,它们在术中、术后均应用Tirofiban.3例患者(3.9%)在住院期间发生不良事件.1个月随访发现1例三支血管病变患者在出院后1周猝死.出院后4～6个月以上随访有4例患者出现心绞痛入院行冠脉造影.其余患者无不适症状等.共有11例患者(14.4%)在支架术后4～7个月复查冠脉造影,再狭窄率为0%.4例出现心绞痛患者造影发现其它血管狭窄(既往存在)而行支架.结论:Cypher雷帕霉素药物洗脱支架在ASTEMI中的应用是安全和有效的,明显减少再狭窄率.
OBJECTIVE: To observe the clinical study of Cypher rapamycin-eluting stent in acute ST-segment elevation myocardial infarction (ASTEMI) .Methods: A total of 76 patients with acute S-elevation myocardial infarction (ASTEMI) admitted to our hospital from October 2003 to June 2005 were enrolled in this study. And PCI, clear lesions after coronary angiography, and then line PTCA and stent placement in the PCI process into the Cypher sirolimus drug-eluting stent.Observation of surgery, hospitalization, after discharge from the hospital without serious adverse cardiac events (including Death, non-fatal acute myocardial infarction, target vessel revascularization rate, re-admission) .Results: All patients underwent radial artery interventional therapy, coronary angiography and stent success rate was 100% .Conclusion Cypher stent 86 , 66 patients were placed in one stent and 10 patients were placed in two stents.For the length of the stent, there were 38 stents with 28 mm in stent and 48 stents with <28 mm.In stent diameter, stent There were 76 scaffolds with 3.0 mm and 10 scaffolds with <3.0 mm.There were 69 cases with TIMI3 grade before infarction-related blood vessel insertion into the stent and 3 cases with no-reflow, , And 3 patients (3.9%) were treated with Tirofiban postoperatively. Adverse events occurred during hospitalization. One patient was followed up for 1 month Three patients died of sudden death 1 week after discharge.After 4 to 6 months of follow-up after discharge, 4 patients had angina pectoris hospital coronary angiography.The remaining patients without symptoms, etc. A total of 11 patients (14.4%) in the stent Coronary angiography was performed 4 to 7 months after surgery, and the rate of restenosis was 0% .Among the 4 patients with angina pectoris angiography, other stenoses of vessel stenosis (formerly) were found.Conclusion: Cypher rapamycin-eluting stent is effective in ASTEMI The application is safe and effective, significantly reducing the rate of restenosis.