中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (4): 693-697.doi: 10.3969/j.issn.1673-8225.2010.04.029

• 骨与关节综述 bone and joint review • 上一篇    下一篇

冠状动脉粥样硬化性心脏病的支架置入治疗现状

刘明伟1，蒋立虹2　   

  1. 1昆明市延安医院急诊科，云南省昆明市  650051； 2云南省心血管病医院心外科，云南省昆明市 650051
  • 出版日期:2010-01-22 发布日期:2010-01-22
  • 作者简介:刘明伟★，男，1975年生，硕士，主治医师，主要从事危重病与免疫的研究。

Current status of percutaneous coronary intervention for treating coronary atherosclerotic heart disease

Liu Ming-wei1, Jiang Li-hong2   

  1. 1 Department of Emergency, Yan’an Hospital, Kunming  650051, Yunnan Province, China; 2 Department of Cardiac Surgery, Yunnan Provincial Hospital for Cardiovascular Disease, Kunming  650051, Yunnan Province, China
  • Online:2010-01-22 Published:2010-01-22
  • About author:Liu Ming-wei★, Master, Attending physician, Department of Emergency, Yan’an Hospital, Kunming 650051, Yunnan Province, China

PDF

573

被引次数

13

摘要：

目的：综述冠心病介入治疗的研究现状以及最新的临床应用试验，展望未来的研究和发展趋势与方向。
方法：由第一作者应用计算机检索PubMed数据库(www.ncbi.nlm.nih.gov/pubmed)。检索时间：2002-01/2009-04。检索词：“drug eluting stents，percutaneous coronary intervention，coronary disease”。计算机初检得到154篇文献，通过阅读标题和摘要进行初筛，排除研究目的与本研究无关的74篇，内容重复的研究53篇，保留27篇英文文献进一步分析。
结果：理想的药物洗脱支架由支架平台，药物载体及药物3者协调构成。随着支架材料学和新型药物的开发，更加有效的支架应用于临床治疗中。最近，大量临床研究数据鼓励临床工作者将其应用于更多的挑战性冠状动脉病例，如慢性完全闭塞病变，多支血管病变等。然而，部分临床研究结果使药物支架引起的晚期血栓而造成的支架安全性问题更加受到关注和重视，因此在药物支架的开发和应用中力求做到安全性和有效性的平衡。在新型的药物支架中，可降解支架，促进内皮愈合涂层支架更具发展前景。
结论：心脏支架置入治疗给冠心病的治疗带来了很多益处，尤其是减少了再狭窄和再次血运重建，但随着对其远期疗效和安全性的重视，药物支架的研制将朝向高效低危发展，对急性冠状动脉综合征患者的治疗疗效及支架断裂的预防仍需进一步研究。

关键词: 冠心病, 介入治疗, 药物洗脱支架, 综述文献, 心血管支架, 医学植入体

Abstract:

OBJECTIVE: To summarize the recent progress and clinical application of percutaneous coronary intervention and to seek the direction of new developments.
METHODS: A computerized online database of Pubmed was searched to identify articles published from May 2000 to February 2009 with the key words of “drug eluting stents, percutaneous coronary intervention, and coronary disease”. There were 154 articles were retrieved by computer, by reading titles and abstracts, 27 literatures were remained after excluding 74 irrespective papers and 53 repetitive studies. 
RESULTS: An ideal drug-eluting stent (DES) was comprised of a platform, a drug carrier vehicle and a pharmaceutical compound in harmony with each other. With the ongoing development of DES materials and drugs, more effective DES was introduced in the practice. Recently, clinical data on DES encourage the interventional cardiologist to use DES in more challenging coronary lesions, such as chronic total occlusions, complex lesions and muiti-vessel lesions. However, the safety and efficacy of DES need further attention. Therefore, novel strategies including bioabsorbable stents, and pro-healing agents coated stents were promising.
CONCLUSION: The development of percutaneous coronary intervention is a breakthrough in intervention cardiology that brings great benefit to patients with coronary disease, especially for restenosis and revascularization. Nevertheless, more endeavour will be necessary to create PCI with high efficacy as well as low risk, and safety and effectiveness of PCI in patients with ST-segment evaluation myocardial infraction and stent fracture prevention need further study.

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