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目的探讨雷帕霉素药物洗脱支架在冠心病合并糖尿病患者经皮冠状动脉介入治疗中应用的临床疗效。方法收集2007年3月至2011年2月在我科住院的35例冠状动脉粥样硬化性心脏病合并糖尿病患者,术前给予阿司匹林及氯吡格雷,术中给予肝素,应用直径1.5～2.0mm球囊充分预扩张后按常规方法进行支架置入,置入长度在15～36mm直径2.5～3.5mm支架,共植入雷帕霉素涂层支架48枚。术后服用氯吡格雷每日75mg,阿司匹林0.1g每日一次。结果 35例患者均手术成功,术后残余狭窄小于10%,胸痛症状均消失,1年内随访无死亡病例,无急性心肌梗死病例发生,有1例患者有支架内再狭窄,给予球囊扩张治疗。结论雷帕霉素药物洗脱支架在冠心病合并糖尿病患者应用有较强的安全性和有效性。
Objective To investigate the clinical efficacy of rapamycin-eluting stent in percutaneous coronary intervention in patients with coronary heart disease complicated with diabetes mellitus. Methods 35 patients with coronary atherosclerotic heart disease and diabetes who were hospitalized in our department from March 2007 to February 2011 were collected. Aspirin and clopidogrel were given preoperatively. Heparin was given intraoperatively and the diameter was 1.5-2.0mm After the balloon was fully pre-expanded, the stent was implanted by conventional methods. The stent was placed in a length of 15 ~ 36mm with a diameter of 2.5 ~ 3.5mm and a total of 48 rapamycin-coated stents were implanted. After taking clopidogrel 75mg daily, aspirin 0.1g once daily. Results All the 35 patients were operated successfully. The postoperative residual stenosis was less than 10%, the symptoms of chest pain disappeared. There were no deaths within one year and no cases of acute myocardial infarction. One patient had in - stent restenosis and balloon dilatation . Conclusion The rapamycin-eluting stent has strong safety and efficacy in the patients with coronary heart disease complicated with diabetes.