【摘要】 目的:探讨在老年急性心肌梗塞(AMI)急诊经皮冠状动脉介入治疗(PCI)中植入雷帕霉素药物洗脱支架(CypherTM)及普通裸支架对C反应蛋白(CRP)及预后的影响。方法:45例老年急性AMI患者,分为CypherTM支架组(n=23)和裸支架组(n=22),所有患者在术前、术后6 h、术后1 d、术后7 d、术后1个月测定CRP,临床随访造影及主要心血管事件。结果:CypherTM支架组23例患者共植入27枚支架,术后TIMI血流3级23例,成功率100%;22例接受随访,随访时间3~11个月,无支架内再狭窄及心血管事件等发生。裸支架组22例患者共植入支架26枚,术后TIMI血流3级21例,临床成功率为95.5%;20例接受随访,随访时间5~13个月,2例患者发生支架内再狭窄(再狭窄率9.09%)。1例猝死,2例新生血管病变。两组术后6 h、术后1 d CRP水平与术前相比明显增高(P<0.05)。两组之间比较差异无显著性。结论:应用CypherTM支架治疗老年AMI近期安全有效。更多还原

【Abstract】 Objective To investigate the effects of rapamycin eluting stent(Cypher^TM) and metal bare stent on the prognosis and C-reactive protein（CRP） in elderly patients with acute myocardial infarction（AMI）.（Methods The） immediate angiographic and clinic follow-up outcomes of 45 elderly patients with AMI reciving Cypher^TM and bare stent were retrospectively analyzed.CRP levels in Cypher^TM and bare stent groups were determined before implantation,6 h,1 d,7 d and 30 d after implantation.Clinical follow-up and major coronary events analysis were developed after operation.Results 27 rapamycin eluting stents were implanted in patients of Cypher^TM group and（26 bare） stents were implanted in patients of bare stent group.The Cypher^TM stents were successfully implanted with 100%.In patients of Cypher^TM group,no serious complications were found in the term of operation and in hospital.There was no restenosis,revascularization and events.In patients of bare stent group,except for（1 patients） with sudden death,angina pectoris occurred in 2 patients,repeat angiography showed that there were new lesions in other coronary arteries of these patients.Restenosis attacked in 2 patients.The concentrations of CRP in Cypher^TM and bare stent groups 6 h and 7 d after operation were much higher than that of（pre-operation （P<0.05））.Conclusion Repamycin eluting stent(Cypher^TM)shows a safety profile and potential efficacy in the treatment of elderly patients with AMI.更多还原