SeQuent Please药物涂层球囊扩张术治疗冠状动脉粥样硬化性心脏病患者临床预后的回顾性分析  

Retrospective analysis of SeQuent Please drug-coated balloon dilatation in the treatment of patients with coronary heart disease

作　　者：李占鲁[1] 王敏[1] 栾毅 赵炎波[1] 傅国胜[1] 黄翯[1] LI Zhan-lu;WANG Min;LUAN Yi;ZHAO Yan-bo;FU Guo-sheng;HUANG He(Department of Cardiology,Sir Run Run Shaw Hospital, Zhejiang University School of Medicine,Hangzhou 310000,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院心内科

出　　处：《中国介入心脏病学杂志》2019年第7期380-385,共6页Chinese Journal of Interventional Cardiology

摘　　要：目的评估SeQuentPlease药物涂层球囊(DCB)扩张术在临床使用的安全性和有效性。方法回顾性分析2015年5月7日至2017年6月28日在浙江大学医学院附属邵逸夫医院因冠状动脉粥样硬化性心脏病行DCB扩张术治疗的246例患者。观察患者预后情况,以发生主要不良心血管事件[MACE,包括心原性死亡、非致死性急性心肌梗死(AMI)及靶病变再次血运重建(TLR)]和TLR为观察终点。结果246例患者中,共包含270处病变,其中支架内再狭窄(ISR)患者117例(47.6%,病变130处),冠状动脉原发小血管病变患者91例(37.0%,病变101处),原发大血管病变患者15例(6.1%,病变16处),慢性完全闭塞病变患者21例(8.5%,病变21处)以及冠状动脉旁路移植术后桥血管病变患者2例(0.8%,病变2处),所有患者共使用312枚DCB。平均随访(18.8±7.7)个月,主要MACE共发生11例(4.5%),其中1例(0.4%)患者确认为心原性死亡,1例(0.4%)患者为非致死性AMI行TLR,9例(4.1%)患者为再狭窄后行TLR。ISR患者TLR发生率(5.1%比2.2%,P=0.276)和MACE发生率(5.1%比3.3%,P=0.520)均较冠状动脉原发小血管病变患者高,但差异无统计学意义。而15例冠状动脉原发大血管病变患者无MACE(包括TLR)发生。结论在临床上,DCB扩张术被证实是一种有效的冠状动脉血运重建策略,无论对ISR患者还是冠状动脉小血管原发病变患者,其应用安全有效,且对大血管原发病变的使用前景同样值得期待。Objective Retrospective evaluation of the safety and eff ectiveness of SeQuent Please drug-coated balloons (DCB) angioplasty in clinical practice.Methods From May 7,2015 to June 28, 2017, a total of 246 patients with coronary heart disease undergoing DCB angioplasty in the Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine were retrospectively included in the fi nal analysis.Major adverse cardiac events[cardiogenic death, non-fatal acute myocardial infarction (AMI) and target-lesion revascularization(TLR)]and TLR were used as outcome endpoints. Results A total of 246 patients with 270 lesions,including 117 patients with in-stent restenosis(ISR, 47.6%,130 lesions),91 patients with small de novo coronary lesions(37.0%,101 lesions),15 cases of large de novo coronary lesions(6.1%,16 lesions),21 cases of chronic total occlusion(8.5%,21 lesions) and 2 cases of bypass stenosis(0.8%,2 lesions).A total of 312 drug-coated balloons were used in all patients.The average follow-up time was(18.8±7.7) months,a total of 11 cases(4.5%)of MACE were occurred,including 1 case(0.4%)of confirmed as cardiogenic death,1 case(0.4%)of non-fatal acute myocardial infarction(AMI),1 case of non-fatal AMI TLR and 9(4.1%)cases of restenosis TLR.There were no signifi cant diff erences in TLR(5.1% vs.2.2%, P =0.276)and MACE(5.1% vs.3.3%, P =0.520) of in-stent restenosis and small de novo coronary lesions.Besides,15 patients with large de novo coronary lesions had no TLR and MACE.Conclusions In clinical practice, DCB angioplasty could be an eff ective coronary revascularization strategy for both in-stent restenosis and small de novo coronary lesions.And the eff ect in large de novo coronary lesion treatment is also worth looking forward to.

关 键 词：冠状动脉粥样硬化性心脏病 药物涂层球囊 主要不良心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]