论文部分内容阅读
目的初步探讨ST段抬高心肌梗死患者在接受急诊PCI后,不同药物洗脱支架对患者的疗效,及血清标志物和ST段的恢复之间的关联。方法前瞻性连续入选ST段抬高型急性心肌梗死患者118人,分为雷帕霉素洗脱支架(66人)与紫杉醇洗脱支架组(52人),统一测定心肌肌钙蛋白(cTnI)、肌酐激酶(CK-MB)、NT-pro-BNP水平、12导联心电图,并对所有入选患者进行12个月临床随访。结果应用两种支架植入100%获得手术成功,术后死亡、支架内血栓和靶病变血运重建等不良事件发生率差异无统计学意义,6-12个月造影随访雷帕霉素组、紫杉醇组再狭窄率分别为8.33%、10.52%。PCI前NT-pro-BNP水平较高的患者ST段不容易完全恢复。结论应用雷帕霉素药物洗脱支架和紫杉醇药物洗脱支架植入对ST段抬高心肌梗死患者的疗效并没有显著的差异。血浆NT-pro-BNP水平是一个能反映介入治疗后ST段恢复的新型独立预后指标。
Objective To investigate the efficacy of different drug-eluting stents in patients with ST-segment elevation myocardial infarction after receiving emergency PCI and the correlation between serum markers and ST-segment recovery. Methods A total of 118 patients with acute ST-segment elevation myocardial infarction were prospectively enrolled. The patients were divided into rapamycin-eluting stent (66 patients) and paclitaxel-eluting stent group (52 patients). Cardiac troponin (cTnI) , Creatinine kinase (CK-MB), NT-pro-BNP level, and 12-lead electrocardiogram. All patients were followed up for 12 months. Results There was no significant difference in the incidence of adverse events such as stent thrombosis and target lesion revascularization after successful application of both stents in 100% surgery, postoperative death, stent thrombosis and target revascularization. The 6-12 months postoperative angiographic follow-up rapamycin group, The restenosis rates of paclitaxel group were 8.33% and 10.52% respectively. ST segment of patients with high level of NT-pro-BNP before PCI can not be completely recovered. Conclusion There is no significant difference in the efficacy of rapamycin-eluting stents and paclitaxel-eluting stents in patients with ST-segment elevation myocardial infarction. Plasma NT-pro-BNP level is a new independent prognostic indicator of ST-segment recovery after interventional therapy.