【摘要】 我们报告2例急性心肌梗死患者置入雷帕霉素涂层支架和紫杉醇涂层支架后发生迟发支架内血栓形成的病例。两例患者均为PCI术后服用氯吡格雷(波立维)75mg/日,10～12个月后改为氯吡格雷(泰嘉)50mg/日,服用2个月(即PCI术后12～14个月)出现支架内血栓形成。我们认为:不能对所有的患者都统一予以双重抗血小板药物治疗3～12个月,对于一些高危患者和高危病变,应当适当延长氯比格雷的服用时间,以减少迟发支架内血栓形成的发生率。PCI术后氯比格雷的使用剂量应为75mg/日,而不是50mg/日。更多还原

【Abstract】 We reported 2 cases of very late in-stent thrombosis after implantation of sirolimus-eluting stent and paclitaxel-eluting stent in patients with acute myocardial infarction (AMI). The patients were prescribed the clopidogrel (75mg per day), and the dosage was decreased to 50mg per day 10-12 months after percutaneous coronary intervention (PCI). The in-stent thrombosis occurred 2 months after the dosage change. We suggested that dual antiplatelet therapy of 3-12 months should not be given to all patients undergoing PCI, and the duration of antiplatelet therapy should be prolonged in high risk patients and in patients with high risk lesion to prevent very late stent thrombosis. The appropriate dose of clopidogrel after PCI was 75mg per day, not 50mg per day.更多还原