崔广凯

[摘要] 目的 探讨雷帕霉素药物洗脱支架在急性ST段抬高型心肌梗死（STEMI）合并糖尿病患者急诊经皮冠状动脉介入（PCI）中应用的安全性与有效性。 方法 选取本院2010年7月～2013年7月收治的STEMI合并2型糖尿病行雷帕霉素药物洗脱支架置入术患者（79例）作为试验组，选取同期收治的STEMI合并2型糖尿病行金属裸支架置入术患者（43例）作为对照组，对比两组患者术后12个月不良心血管事件发生率及术后即刻、24 h、48 h、72 h血小板聚集情况。 结果 试验组患者术后12个月死亡、再梗死、再次靶血管重建等主要不良心血管事件发生率均明显低于对照组，差异有统计学意义（P＜0.05）。两组患者术前即刻、术后即刻及术后24 h血小板聚集情况差异无统计学意义（P>0.05），试验组患者术后48、72 h血小板聚集情况明显优于对照组，差异有统计学意义（P＜0.05）。两组患者术后24 h、术后1个月等近期再狭窄发生率差异无统计学意义（P>0.05），试验组患者术后6、12个月再狭窄发生率（8.86%、11.39%）明显低于对照组（25.58%、32.56%），差异有统计学意义（P＜0.05）。 结论 STEMI合并糖尿病患者行急诊PCI术后置入支架能在一定程度上改善心肌再灌注情况，且雷帕霉素药物洗脱支架相较于金属裸支架具有更好的远期疗效，其远期不良心血管事件发生率明显偏低，心肌组织水平再灌注情况优势明显，有助于改善患者术后的生活水平。

[关键词] 雷帕霉素；药物洗脱支架；ST段抬高型心肌梗死；糖尿病

[中图分类号] R542.2+2[文献标识码] B[文章编号] 1674-4721（2014）05（c）-0156-03

Application of rapamycin drug-eluting stents on emergency percutaneous coronary intervention in patients with ST elevation myocardial infarction and diabetes

CUI Guang-kai

Department of Cardiology,Liaoyang Petrochemical General Hospital of Liaoning Province,Liaoyang 111003,China

[Abstract] Objective To study the safety and efficacy of rapamycin drug-eluting stents on emergency percutaneous coronary intervention (PCI) in patients with ST elevation myocardial infarction (STEMI) and diabetes. Methods 79 cases of patients with STEMI and type 2 diabetes were selected from July 2010 to July 2013 in our hospital as the experimental group,who were given with rapamycin eluting stent implantation.43 cases of patients with STEMI and type 2 diabetes were selected as control group at the same time,who were embedded bare metal stents.The incidence of major adverse cardiovascular events 12 months later and the rate of platelet aggregating after PCI of two groups were compared. Results The incidence rate of death,reinfarction,target vessel revascularization in experimental group after 12 months treatment was lower than that of the control group respectively,the difference was significant (P<0.05).The platelet aggregation at immediately before surgery,immediately after surgery and 24 h after surgery of two groups had no significant difference (P>0.05);and at 48,72 h after surgery in experimental group was better than that of the control group respectively,the difference was significant (P<0.05).The incidence of restenosis after 24 h surgery and a month of two groups had no significant difference (P>0.05),after 6 and 12 months surgery in the experimental group (8.86%,11.39%) was lower than that of the control group (25.58%,32.56%) respectively,the difference was significant (P<0.05). Conclusion The application of drug-eluting stents in patients with STEMI and diabetes after emergency PCI can improve the situation myocardial reperfusion,rapamycin eluting stents has a better long term curative effect than bare metal stents,which can reduce the incidence of major adverse cardiovascular events,increase the myocardial tissue reperfusion,improve the living level of patients.

[Key words] Rapamycin;Drug-eluting stents;ST elevation myocardial infarction;Diabetes

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近年来，随着研究进展的不断深入，原发性置入支架在降低心脏事……