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目的:观察华法林预防冠脉支架术后血栓形成的有效性和安全性。方法:冠脉支架术后患者78例分为2组,金属裸支架组和药物涂层支架组。在常规治疗的基础上,调整华法林剂量,使INR值保持在2.0左右,观察早期和晚期支架术后患者心绞痛、心肌梗死等临床急性事件的发生及出血并发症。结果:使用华法林后,两组早期未见临床急性事件出现,也未见出血并发症,晚期出现心绞痛两组分别为3例与1例,未发生心肌梗死事件和出血。对4例心绞痛患者再次行冠脉造影显示,置入支架处未见血栓及再狭窄,而是其他血管和血管段出现了冠脉狭窄。结论:华法林可防止冠脉支架术后血管形成的急性事件,无论是金属裸支架或药物支架,只要剂量适当,这种作用是安全有效的。
Objective: To observe the effectiveness and safety of warfarin in preventing thrombosis after coronary stent. Methods: Seventy-eight patients with coronary stent were divided into two groups: bare metal stent group and drug-coated stent group. On the basis of routine treatment, the dosage of warfarin was adjusted so that the INR value was maintained at about 2.0. The occurrence of acute clinical events such as angina pectoris and myocardial infarction and bleeding complications in patients with early and advanced stenting were observed. Results: There was no clinical acute event and no bleeding complications in both groups after early warfarin. There were 3 cases and 1 case of angina pectoris in late stage. No myocardial infarction and bleeding occurred. Coronary angiography was performed on 4 patients with angina pectoris. No thrombus and restenosis were placed in the stent, but coronary stenosis occurred in other blood vessels and blood vessels. CONCLUSIONS: Warfarin is safe and effective in preventing acute events of post-coronary angiogenesis, either in bare-metal or drug-eluting stents, as long as the dose is appropriate.