药物涂层球囊在冠状动脉分支开口病变中的应用  

Drug-coated balloon in small branch ostial lesions of coronary arteries

作　　者：翟东东 高炬[1] 张萌[1] 刘鸿宇[1] 王斌[1] 曲涛[1] 

机构地区：[1]航天中心医院心脏医学部,北京100049

出　　处：《中国介入心脏病学杂志》2017年第7期390-394,共5页Chinese Journal of Interventional Cardiology

基　　金：中国航天科工集团公司医疗卫生科研项目(2016-LCYL-005)

摘　　要：目的评价药物涂层球囊在经皮冠状动脉介入治疗分支开口病变(Medina 0,0,1型)的有效性和近期疗效。方法符合入选条件的患者共48例,随机分为药物涂层球囊(drug coated balloon,DCB)血管成形术治疗组(DCB组)和切割球囊(cutting balloon,CB)血管成形术治疗组(CB组)。DCB组应用DCB扩张治疗靶病变,CB组用CB扩张治疗靶病变,分析比较术中即刻效果及远期预后。结果术前两组临床资料比较,差异无统计学意义。术中两组间均无冠状动脉穿孔、心脏压塞、急性血栓事件发生。两组病变血管最小内径(minimal lumen diameter,MLD)术前及术后即刻比较,差异无统计学意义;DCB组的随访MLD[(1.8±0.2)mm比(1.5±0.3)mm,P=0.006]明显优于CB组,差异有统计学意义;随访期间无死亡、非致死性心肌梗死、血运重建发生。结论在冠状动脉分支开口病变治疗中,DCB与CB治疗相比,即刻效果相似,但近期疗效优于CB。Objective To evaluate the safety and efficacy of drug-coated balloon in small branch ostial lesions of coronary arteries（ Medina type 0,0,1 lesion）. Methods A total of 48 patients were enrolled in the study and they were randomly divided into the Drug-Coated Balloon（ DCB） angioplasty group（ 22 cases） and the Cutting Balloon（ CB） angioplasty group（ 26 cases）. They underwent percutaneous coronary intervention（ PCI） with either DCB or with CB in small branch ostial lesions of coronary arteries respectively,The immediate outcomes and long-term efficacy were investigated. Results There were no statistical differences between the two groups in baseline clinical date before PCI. There were no coronary perforation,pericardial tamponade,acute thrombotic events in the two groups. There was no significant difference in minimal lumen diameter（ MLD） immediately after PCI between the two groups. During followup angiography,the MLD in the DCB group was significantly larger than in the CB group [（ 1. 8 ± 0. 2） mm vs.（ 1. 5 ± 0. 3） mm,P = 0. 006]. There were no death,nonfatal myocardial infarction or revascularization recorded in the groups during 6 months of follow-up. Conclusion The immediate outcomes between DCB and CB were similar in small branch ostial lesions for coronary arteries angioplasty. The long-term efficacy of DCB angioplasty is better than CB angioplasty.

关 键 词：经皮冠状动脉介入治疗 切割球囊 药物涂层球囊 分支开口病变 

分 类 号：R541.4[医药卫生—心血管疾病]