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目的:探讨ST段抬高性心肌梗死患者经皮冠状动脉介入置入雷帕霉素药物洗脱支架内血栓形成的相关因素及预后。方法:845例ST段抬高型心肌梗死患者行直接经皮冠状动脉介入置入雷帕霉素药物洗脱支架,随访6个月,分析21例发生血栓形成的相关因素及预后。结果:血栓形成发生率2.49%,血栓形成组与无血栓形成组在年龄、糖尿病、左室射血分数、停用氯吡格雷、6个月病死率、再次靶血管重建率及再次靶病变重建率等方面差异有统计学意义(P<0.05)。多因素分析显示糖尿病史、左室射血分数、停用抗血小板药物、前降支病变、支架直径、数量及长度是血栓形成的独立影响因素。结论:雷帕霉素药物洗脱支架血栓形成是多因素相关的临床事件,患者病死率高,预后差,应引起高度重视。
Objective: To investigate the related factors and prognosis of stent thrombosis after percutaneous coronary intervention in rapamycin-eluting stenting in patients with ST-segment elevation myocardial infarction. Methods: 845 patients with ST-segment elevation myocardial infarction underwent direct percutaneous coronary intervention with rapamycin-eluting stent. The patients were followed up for 6 months. The related factors and prognosis of 21 patients with thrombosis were analyzed. Results: The incidence of thrombosis was 2.49%. There were no significant differences in age, diabetes mellitus, left ventricular ejection fraction, discontinuation of clopidogrel, 6 months mortality, target revascularization rate and re-target lesion reconstruction in thrombosis group and non-thrombosis group Rate and other differences were statistically significant (P <0.05). Multivariate analysis showed that history of diabetes, left ventricular ejection fraction, discontinuation of antiplatelet drugs, anterior descending coronary artery disease, stent diameter, number and length were independent factors of thrombosis. Conclusion: The rapamycin-eluting stent thrombosis is a multi-factor related clinical event. The high mortality and poor prognosis of patients should pay close attention to it.