CAJ | 학술논문

目的评估Firebird药物洗脱支架(DES)加替罗非班与Cypher支架加替罗非班治疗急性冠脉综合征(ACS)病人的安全性和有效性.方法 2005年7月至2007年7月323例ACS病人,其中接受Firebird支架(Firebird组)161例,接受Cypher支架(Cypher组)162例.两组同时加用替罗非班.首先给予负荷量10μg·kg-1,3 min内静注完毕,之后以0.15 μg·kg-1·min-1的速度微量泵持续静点36 h.比较两组支架植入后即刻到近期的有效性和安全性,并于30 d内进行随访,比较有效性和主要不良心脏事件的发生率.结果 Firebird组与Cypher组比较,术前左室射血分数、靶病变的部位、血小板计数、血红蛋白、红细胞压积差异均无统计学意义.两组手术成功率均为100%,术后出血并发症、血小板计数、血红蛋白、红细胞压积差异均无统计学意义,两组各有2例发生支架内急性血栓(1.2% vs 1.2%,P＞0.05).均无亚急性血栓发生、非致死性心肌梗死各2例(1.3% vs 1.3%)、靶血管再次重建分别为1例(0.6%),2例(1.3%)、再住院分别为2例(1.3%)1例(0.6%)差异均无统计学意义(均P＞0.05).30 d随访均未见支架内再狭窄.结论 Firebird药物洗脱支架加用冠替罗非班治疗ACS均有较好的安全性和有效性,具有与Cypher支架相似的临床疗效.
목적 평고Firebird약물세탈지가(DES)가체라비반여Cypher지가가체라비반치료급성관맥종합정(ACS)병인적안전성화유효성.방법 2005년7월지2007년7월323례ACS병인,기중접수Firebird지가(Firebird조)161례,접수Cypher지가(Cypher조)162례.량조동시가용체라비반.수선급여부하량10μg·kg-1,3 min내정주완필,지후이0.15 μg·kg-1·min-1적속도미량빙지속정점36 h.비교량조지가식입후즉각도근기적유효성화안전성,병우30 d내진행수방,비교유효성화주요불양심장사건적발생솔.결과 Firebird조여Cypher조비교,술전좌실사혈분수、파병변적부위、혈소판계수、혈홍단백、홍세포압적차이균무통계학의의.량조수술성공솔균위100%,술후출혈병발증、혈소판계수、혈홍단백、홍세포압적차이균무통계학의의,량조각유2례발생지가내급성혈전(1.2% vs 1.2%,P＞0.05).균무아급성혈전발생、비치사성심기경사각2례(1.3% vs 1.3%)、파혈관재차중건분별위1례(0.6%),2례(1.3%)、재주원분별위2례(1.3%)1례(0.6%)차이균무통계학의의(균P＞0.05).30 d수방균미견지가내재협착.결론 Firebird약물세탈지가가용관체라비반치료ACS균유교호적안전성화유효성,구유여Cypher지가상사적림상료효.
Objective To evaluate the safety and efficacy of Firebird drug-eluting stent(DES)combining Tirofiban and Cypher DES combining Tirofiban in patients with acute coronary syndrome(ACS).Methods 323 ACS patients were divided into 2 general conditions-matched groups:Firebird group(n=161)undergoing Firebird DES implantation and Tirofiban intravenous injection 10μg·kg-1 within 3 minutes followed by Tirofiban 0.15 μg·kg-1·min-1 intravenous maintenance infusion with micro pump for 36 hours,and Cypher group(n=162)undergoing Cypher DES implantation and Tirofiban.The safety was observed instantly and 36 h after the implantation.The patients were followed up for 30 d.Some patients in the Firebird group underwent coronary angiography and intravascular ultrasound because of angina and part of target vessels underwent revaseularizition.Results There were no significant difierences between the 2 groups in ejection fraction target coronary lesion type,blood platelet count,HB and HCT before treatment.The success rates of operation were both 100% in these 2 groups.No complication occurred in both groups.There were not significant difiefences in the blood platelet count.hemoglobin.hematocrit,acute stent thrombosis rate(1.2% vs 1.2%),acute myocardial irffarction rate(1.3% vs 1.3%),target vessel revaseularization rate(0.6% vs 1.3%),and rehospitalization rate(1.3% vs 0.7%)(all P＞0.05).30 d no in-stent restenosis was found by angiographic and intravascular ultrasound follow-up in the Firebird group.Condusion Firebird DES combining Tirofibun and Cypher DES combining Tirofiban are both safe and effective in treating ACS.