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目的 探讨雷帕霉素药物洗脱支架 (cypherTM)在急性ST段抬高心肌梗死 (STEMI)急诊经皮冠状动脉介入治疗 (PCI)中应用的安全性和有效性。方法 选择 2 0 0 2年 11月至 2 0 0 4年 2月的STEMI患者 96例 ,随机分为两组 :药物洗脱支架组 ( 4 8例 )和普通支架组 ( 4 8例 ) ,所有患者均于发病12h内行急诊PCI治疗 ,一组置入cypherTM ,另一组置入普通支架。结果 96例患者急诊PCI治疗均获得成功。 4 8支梗死相关血管 (IRA)的 4 8处罪犯病变置入 4 9枚药物洗脱支架 ,另 4 8支IRA的 4 9处病变置入 4 9枚普通支架。未发生与介入治疗有关的并发症 ,其中 1例置入cypherTM 者术后出现脑梗死 ,于第 7天死于多器官功能衰竭。药物支架组和普通支架组相比较 ,PCI后造影结果和临床结果差异均无显著性。随后对 95例病人进行了 1～ 9个月随访 (平均 4 5± 2 6个月 ) ,药物支架组患者未发生任何心血管事件 ,普通支架组有 2例发生心绞痛。结论 cypherTM 在STEMI急诊PCI中应用与普通支架一样有较强的安全性和有效性
Objective To investigate the safety and efficacy of rapamycin-eluting stent (cypherTM) for acute percutaneous coronary intervention (PCI) in acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 96 STEMI patients from November 2002 to February 2004 were randomly divided into two groups: drug-eluting stent group (48 cases) and general stent group (48 cases) Patients were treated with emergency PCI within 12 hours of onset, one group was placed cypherTM, the other group was placed in a common stent. Results 96 cases of emergency PCI were successful. Four forty-eight drug-eluting stents were placed in 48 crippled lesions of 48 IRA vessels, and 49 common stents were placed in 49 lesions of 48 IRA patients. No complications related to interventional therapy occurred. One of the patients who had been infused with cypherTM developed cerebral infarction and died of multiple organ failure on the seventh day. There was no significant difference between PCI group and conventional stent group after PCI. Subsequently, 95 patients were followed up for 1 to 9 months (mean, mean ± SD, 45 ± 2 6 months). No cardiovascular events occurred in the drug-eluting stent group. Anginal pectoris occurred in 2 of the 2 stent-graft groups. Conclusions cypherTM has the same safety and effectiveness as ST as PCI in STEMI emergency PCI