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目的:探讨国产雷帕霉素药物洗脱支架(Firebird)在急性冠状动脉综合征(ACS)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2004年1月至2007年9月间的ACS患者118例,于发病12h内行急诊PCI治疗,于梗死相关血管的靶病变处置入Firebird支架。记录1个月和6个月随访终点时的主要心脏不良事件(包括死亡、再发心肌梗死、靶血管再成形等)发生率、支架内血栓发生率、支架内再狭窄发生率。结果:118例患者急诊PCI治疗均获得成功。118支梗死相关血管的125处罪犯病变共置入140枚Firebird支架,12例患者出现无复流现象,1例应用主动脉内气囊反搏术,6例出现心室颤动,18例出现一过性室性心动过速。10例出现一过性低血压,术后2例发生穿刺部位血肿。仅1例患者于术后第3天因再发急性心肌梗死死亡,1个月随访终点时主要心脏不良事件为0.8%。6个月随访终点时有28例接受了冠状动脉造影复查(造影随访率23.9%),无支架内再狭窄发生,无主要心脏不良事件。结论:Firebird支架在ACS急诊PCI中应用与普通支架一样有较高的安全性和有效性,并可以明显降低再狭窄率。
Objective: To investigate the safety and efficacy of the domestic Rapamycin-eluting stent (Firebird) in the treatment of acute coronary syndrome (ACS) in patients undergoing percutaneous coronary intervention (PCI). METHODS: One hundred and eighty-eight ACS patients between January 2004 and September 2007 were enrolled in this study. Emergency PCI was performed within 12 hours of onset and Firebird stent was placed on target lesion of infarct-related blood vessels. The incidence of major cardiac adverse events (including death, recurrent myocardial infarction, target vessel reshaping, etc.) at 1-month and 6-month follow-up were recorded. The incidence of stent thrombosis and the incidence of in-stent restenosis were recorded. Results: All 118 patients underwent emergency PCI. Of the 118 crippled lesions in 118 infarcted vessels, 140 Firebird scaffolds were implanted. No reflow phenomenon was observed in 12 patients, intra-aortic balloon counterpulsation in 1, ventricular fibrillation in 6 and transient in 18 Ventricular tachycardia. 10 cases of transient hypotension, 2 cases of puncture site hematoma occurred. Only one patient died of recurrent acute myocardial infarction on the third postoperative day, with a major adverse cardiac event of 0.8% at the end of the month. Twenty-eight patients underwent coronary angiography (angiographic follow-up of 23.9%) at the end of the 6-month follow-up. No in-stent restenosis occurred and no major cardiac adverse events occurred. Conclusion: The application of Firebird stent in ACS emergency PCI has the same safety and effectiveness as common stent, and can significantly reduce the rate of restenosis.