合理看待药物洗脱支架晚期血栓问题

心血管病学进展2007年第28卷第4期　AdvCardiovascDis,July2007,Vol.28,No.4 513

●危险因素:年龄≥60岁、癌症、VTE病史、肥胖、静脉曲张、慢性心脏病、慢性肺病、激素治疗;

第三步:给予预防VTE的治疗2周(无禁忌证时):

●LMWH或肝素,采用临床研究证实安全、有效的剂量;

●弹力袜下肢加压(存在抗凝禁忌证时)。

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收稿日期:2007207203

(本文编辑:郭　宪)

合理看待药物洗脱支架晚期血栓问题

刘　健　王伟民　综述

(北京大学人民医院心脏中心,　北京　100000)

Drug2ElutingStentandLateStentThrombosis

LIUJian,　WANGWei2min

(HeartCentre,People’sHospitalofPekingUniversity,　Beijing　100000,　China)

文章编号:100423934(2007)0420513205　　　　　中图分类号:R815;R364.1+5　　　　　文献标识码:A

　　摘要:　冠状动脉支架现广泛应用于冠心病的介入治疗中。支架内血栓是金属裸支架和药物洗脱支架的一个并发症,可导致心肌梗死或死亡。最近,药物洗脱支架引起晚期支架内血栓的问题引起人们的广泛关注。支架血栓的危险因素包括操作因素(如支架贴壁不良、置入支架的数目、支架长度及夹层)、患者及病变因素、过早停用抗血小板药物以及支架释放的药物使内皮延迟愈合等。现对支架晚期血栓的概念、发生的危险因素、防治措施等进行探讨。

关键词:　药物洗脱支架;支架血栓

Abstract:　Coronarystentsarewidelyusedduringpercutaneouscoronaryinterventionproceduresnowadays.Stentthrombosis,acom2plicationofbothbare2metalstents(BMS)anddrug2elutingstents(DES),isassociatedwithhighratesofmyocardialinfarctionanddeath.Re2cently,theadventofDEShasraisedconcernsregardinglateroccurrenceofstentthrombosis,whereasotherdatasuggestanabsentofsucharisk.Severalfactorsareassociatedwithanincreasedriskofstentthrombosis,includingtheprocedureitself,patientandlesioncharacteristics,stentdesign,andprematurecessationofantiplateletdrugs.

Keywords:　drug2elutingstent;late;stentthrombosis

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