胡大一教授回应“一半的心脏支架不靠谱”报道 Doc hu dayi response"Half of the heart stent by spectrum"reports

“好医生要坚守三个不变” "A good doctor should stick to three unchanged"

　　这两天，一则“一半的心脏支架不靠谱”的报道引起了很多人的关注，特别是一些安了支架的人更是惴惴不安。这篇报道中提到：“我国著名心血管专家胡大一在近日举行的第23届长城国际心脏病学会议上说，大家都非常迷信支架，崇拜搭桥。它对急性心肌梗死非常有效，但根据现在的统计资料，一半的支架都不靠谱儿。因此，在稳定的情况下，我作为心脏科大夫不建议盲目做支架。”

These two days,a"Half of the heart stent by spectrum"Reports caused many people's attention,Especially some Ann the support of the people but also on pins and needles.The report mentioned:"Our country famous cardiovascular experts held recently b in the 23rd the Great Wall international cardiology conference said,Everyone was very superstitious support,Worship bypass.It is very effective for acute myocardial infarction,But according to the statistical data of the now,Half of the support are PuEr without.therefore,In the stable cases,I as a heart doctor do not recommend blind do support."

　　针对支架滥用的问题，今天上午，胡大一教授在接受本报记者专访时表示，无论时代怎么变化，好医生要坚守三个不变：第一，患者利益至上的价值观不能改变。医生不能伤害患者利益；第二，医生追求的医学目的不能改变。医学的目的是促进健康，预防疾病。一位35岁的患者得了心肌梗死，无论手术怎么成功，都是悲剧和遗憾。与其说是治疗的开始，不如说是医学的失败；第三，医生的责任不能改变。医生的责任是推动基本医疗服务公平可及，让人人享受医疗服务。

To support the problem of abuse,This morning,Professor b in accepting our newspaper reporter to interview, said,No matter how times change,A good doctor should stick to three unchanged:The first,Patients interest as the highest values can't change.The doctor can't hurt patients benefit;The second,The doctor the pursuit of medical purpose can't change.Medical purpose is to promote health,Prevent disease.A 35 year old patients got myocardial infarction,No matter how successful surgery,All is a tragedy and regret.Is not so much the start of treatment,Rather than the failure of the medicine;The third,The doctor's responsibility can't change.The doctor's responsibility is to promote the basic medical service and fair,Let everyone enjoy medical treatment service.

不需安支架也植入属于滥用 Does not need to Ann stent implantation also belong to abuse

　　昨晚，胡大一在其实名注册的微博上表示，“有关媒体报道所述支架半数不靠谱，甚不严谨。”“关于支架，我反复讲的观点是：急性心肌梗死，时间就是生命，越早开通血管越好！稳定心绞痛患者是否植入支架要掌握好指证。美国数据显示：稳定性心绞痛植入支架的50%指证不强，其中11.6%不合理，38%指证不确定。中国应加强支架预后研究。”

Last night,B in actually registered micro bo said,"The media reports stated support half without spectrum,Was not rigorous.""About support,I broken point is:Acute myocardial infarction,Time is life,The earlier the better opening blood vessels!Whether patients with stable angina pectoris stent to master a testify.The data showed that:With stable angina, 50% of the stent prove is not strong,11.6% of them is not reasonable,Prove not sure 38%.China should strengthen the support prognosis research."

　　今天上午，胡大一教授在接受本报记者专访时进一步阐述了他的观点。胡大一说，对于一名急性心肌梗死的患者来说，由于血管“梗”了，所以必须要打通血管通道，安支架是打通血管的很重要方法之一，通过一个小切口放进一个支架就能救命。但对于稳定性心绞痛患者来说，相当多的患者从支架的获益限于缓解心绞痛症状，如狭窄的血管部位不关键，用药后，无明显症状，支架治疗无必要。安支架一定需要掌握好指证。也就是说，需要安支架的才能安支架，不需要安放支架也植入，就属于不恰当使用或过度使用甚至滥用。

This morning,Professor b in accepting our newspaper reporter to interview with further expounds his point of view.B said,For an acute myocardial infarction patients speaking,Due to the blood vessels"terrier"the,So we must get through vascular channels,Ann support is through the blood vessels of the very important one of the method,Through a small incision into a support can help.But for stable angina for patients,Quite a number of patients benefit from stents to relieve angina symptoms,Such as the narrow vascular parts not key,after,No obvious symptoms,Stents for treatment of unnecessary.Ann support must need to master testify.That is,Need to Ann stents to Ann support,Don't need stent placement also implanted,It belongs to the improper use or excessive use of even abuse.

　　数据显示，在美国，稳定性心绞痛植入支架的50%指证不强。具体到我国，还没有相关的数据，但是我国也存在稳定性心脏病患者心脏支架“放得太多”的情况，而且不是个别现象。特别是有些患者一次放入3个以上支架，有的甚至被放入十几个，植入的支架内也会再狭窄或出血栓。“很少人需要植入3个以上的支架”。

Data display,In the United States,With stable angina, 50% of the stent prove is not strong.Specific to our country,Still does not have relevant data,But our country also exist stability heart patients heart stent"Put too much"situation,And is not the individual phenomenon.Especially some patients a into three or more support,Some even are placed in a dozen,Implanted stent will also restenosis or out of the thrombus."Few people need to implant three or more support".

安了支架不能一劳永逸 Ann the stents can't get STH done once and for ever

　　即使是符合指证放了支架的人，也不能一劳永逸，而是需要改变生活方式，否则原有疾病还有可能复发。

Even if is conform to testify put support people,Also can't get STH done once and for ever,But need to change the way of life,Otherwise the original disease and likely to recur.

　　胡大一说，心血管疾病大多数不是先天性的，而是生活方式不健康造成的，被称为生活方式病。许多人并不想改变自己的生活方式，而是觉得吃药、打针太麻烦，认为只要放了支架，心脏就相当于上了保险，就可以一劳永逸。其实，心血管病到了需要放支架的程度，只是多害相较取其轻，“没办法的办法”。

B said,Cardiovascular disease most not congenital,But the way of life not health cause,Called lifestyle disease.Many people don't want to change his way of life,But think to take medicine/Injections too much trouble,Think as long as put to support,The heart is equivalent to the insurance,Can get STH done once and for ever.In fact,Cardiovascular disease to need to put the degree of support,Just more harm than take its light,"You have no choice".

　　胡大一的老师是一位著名的心脏科医生，84岁时出现心绞痛，他没去做冠脉造影、放支架，而是在保持健康生活方式的基础上，坚持口服药物，现在年近九旬，仍可以轻松爬上二楼。即使需要做手术，心脏搭桥手术已有半个多世纪的发展史，技术非常成熟，但却因为创伤大做借口，一些医生不愿选择。

B teacher is a famous heart doctor,84 years old appeared angina pectoris,He didn't go to do coronary angiography/Put support,But in the healthy way of life basis,Insist on oral drug,Now nearly,Still can easily climbed up to the second floor.Even if the need to do surgery,Heart bypass surgery for more than half a century of history,Technology is very mature,But because of our wounds big as an excuse,Some doctors don't want to choose.

　　胡大一说，患者放入支架后要吃一年的氯吡格雷、终身服用阿司匹林对抗血栓，这两种药物还会带来出血风险。他自己就遇到过一些“回炉”患者，他们有些并不符合介入治疗的适应症，却被植入一个甚至多个支架，由于术后未按时服药，出现血栓，导致更严重的心肌梗死。

B said,Patients after inserting a stent to eat a year of clopidogrel/Lifelong aspirin use against thrombus,The two drugs will also bring risk of bleeding.He himself was met some"down"patients,Some of them does not conform to the intervention treatment indications,But be implanted into an even more support,Due to no postoperative medicine on time,Blood clot,Lead to a more serious myocardial infarction.

不要盲目做冠状动脉造影 Don't blindly do coronary artery angiography

　　胡教授表示，目前冠状动脉CT也做得过于泛滥，一些患者毫无心绞痛症状，狭窄也不严重，可以做运动负荷试验，评价有无心肌缺血，不要盲目做冠状动脉造影或支架。(记者 贾晓宏)

Professor hu said,At present coronary artery CT also doing too flood,Some patients have no angina symptoms,Stenosis is not serious,Can do exercise load test,Evaluation for myocardial ischemia,Don't blindly do coronary artery angiography or support.(Reporter JiaXiaoHong)