雷帕霉素洗脱支架临床应用1年随访论文
2015-07-20 01:11
导读：药学论文毕业论文，雷帕霉素洗脱支架临床应用1年随访论文样式参考，免费教你怎么写，格式要求，科教论文网提供大量范文样本：
作者：赵慧强，贾国良，郭文怡，王海昌，李伟杰，栾荣华，吕
作者：赵慧强，贾国良，郭文怡，王海昌，李伟杰，栾荣华，吕安林，李成祥，李虎，王晓燕
【关键词】 冠状动脉疾病
【Abstract】 AIM: To investigate the efficacy and safety of rapamycin eluting stents (CypherTM) during 1year followup. METHODS: The immediate angiographic and clinical followup outcomes were analyzed retrospectively in 112 patients who had received CypherTM. RESULTS: One hundred and seventythree lesions were treated and 227 stents were implanted in the 112 patients. One hundred and fiftynine slow release rapamycin eluting stents were implanted in 132 lesions. The CypherTM stents were successfully implanted in 156/159 lesions (98.1%). High pressure balloon was used for stent deployment in 2 lesions with severe calcification. Dissection occurred at the distal side of stent in 1 lesion. No serious complications were found during operation and hospitalization. Clinical followup of 102 patients was conducted for 12 months and 1 patient died of cardiac death and angina pectoris occurred in 10 patients. Angiography was conducted again in the all 10 patients, and 6 restenosis in bare stents and 4 new lesions in other coronary arteries were found. Angiography was performed for a second time in 30 of 112 followedup patients, showing only 1 restenosis in CypherTM stent. CONCLUSION: CypherTM is safe and effective in the treatment of coronary lesions.
【Keywords】 sirolimus; stents; coronary disease
【摘要】 目的： 评价雷帕霉素洗脱支架（CypherTM）1 a的安全性及有效性. 方法： 回顾分析112例接受CypherTM支架置入术冠心病患者的即刻疗效和临床随访结果. 结果： 共处理112例患者173处病变，置入支架227枚，其中132处病变置入159枚CypherTM支架. 除2处严重钙化病变需辅以高压球囊才能充分扩张，1处支架近端发生内膜撕裂，其余全部成功置入. 手术过程及住院期间无严重并发症发生，成功率98.1%. 112例患者中102例得到随诊,平均随访1 a（≥12 mo），1例死亡，10例患者心绞痛再发，其中，6例为普通金属支架内的再狭窄（6例中1例伴CypherTM支架内近端再狭窄），4例为其他分支的新病变. 30例复查了冠状动脉造影，1例CypherTM支架内近端再狭窄. 结论： CypherTM支架临床应用安全，能显著降低再狭窄率.
中国大学排名
【关键词】 西罗莫司；支架；冠状动脉疾病
0引言
经皮冠状动脉介入治疗（Percutaneous coronary intervention, PCI）是目前治疗冠心病最有效的非手术方法，冠状动脉内支架的应用，使术后3~6 mo的再狭窄率自单纯PTCA时代的30%~50%降至20%~30%，但支架内再狭窄难以防治. 现在发展成熟的药物洗脱支架为解决这一难题带来了新的希望，目前冠心病介入治疗已经进入了“药物洗脱支架”的第三个里程碑时代. 雷帕霉素是一种天然的大环内酯类抗生素，通过阻止细胞周期G1S的转化，抑制细胞的增殖，用于器官移植的排斥反应. 雷帕霉素也可通过阻止平滑肌细胞增生和迁移而减少再狭窄. 雷帕霉素洗脱支架（CypherTM）是一种慢速释放雷帕霉素的药物洗脱支架. 我们总结了我科应用CypherTM支架的初步经验，以进一步了解CypherTM支架的安全性和有效性.
1对象和方法
1.1对象
全部病例为200302/200401行PCI术的患者，根据病变及患者需要置入CypherTM支架共112（男89，女23）例，平均年龄62.3±17.5（46～79）岁. 其中，稳定型心绞痛18例（16.1%），不稳定型心绞痛76例（67.9%），急性心肌梗死6例（5.4%），陈旧性心肌梗死12例（10.7%）. 吸烟者54例（48.2%），高血压病46例（41.4%），糖尿病38例（33.9%），高脂血症25例（22.3%）.
