药物球囊主动保护技术在冠状动脉分叉病变中的远期临床获益研究  

Long-term clinical benefit of drug balloon active protection in coronary artery bifurcation lesions

作　　者：陈伟泉 梁茂锦 陈许宁 梁伦昌 Chen Weiquan;Liang Maojin;Chen Xuning;Liang Lunchang(Department of Cardiovascular Medicine,Luoding People's Hospital,Luoding 527200,China)

机构地区：[1]广东省罗定市人民医院心血管内科,527200

出　　处：《国际医药卫生导报》2021年第23期3674-3678,共5页International Medicine and Health Guidance News

基　　金：云浮市科技计划项目(200528105446304)。

摘　　要：目的探讨药物球囊主动保护技术在冠状动脉分叉病变中的远期临床效果。方法随机纳入罗定市人民医院2018年1月至2019年1月确诊为冠状动脉分叉病变患者78例,采用随机数字法将患者分为药物球囊主动保护组和普通球囊主动保护组,每组39例,行标准介入治疗,术后随访12个月。观察两组患者的术后TIMI分级、心血管主要不良事件发生率(MACE)发生率、主支和分支血管最小管腔直径(MLD)、血管狭窄程度以及分支血管晚期管腔丢失(LLL)。结果两组患者在术后即刻主支、分支血管血流达TIMI 3级的概率比较差异均无统计学意义(均P>0.05)。术后长期随访过程中药物球囊主动保护组的MACE发生率明显低于普通球囊主动保护组[5.12%(2/39)比25.64%(10/39)],差异有统计学意义(χ^(2)=6.303,P=0.012)。在术前、术后即刻两组患者主支、分支血管MLD、血管狭窄程度以及术后9个月、12个月主支血管MLD、血管狭窄程度比较差异均无统计学意义(均P>0.05);在随访的术后9个月、12个月时药物球囊主动保护组分支血管MLD均明显高于普通球囊主动保护组[(2.30±0.20)mm比(2.12±0.22)mm、(2.20±0.18)mm比(2.03±0.15)mm],分支血管狭窄程度均明显低于普通球囊主动保护组[(8.05±1.31)%比(8.92±1.35)%、(8.23±1.46)%比(9.22±1.40)%],差异均有统计学意义(均P<0.05)。12个月药物球囊主动保护组分支血管LLL明显低于普通球囊主动保护组(t=11.152,P<0.001)。结论药物球囊主动保护技术在冠状动脉分叉病变治疗的应用中可以带来更低的MACE,LLL发生率以及分支血管再狭窄率更低,远期临床治疗效果更佳,值得推广使用。Objective To explore the long-term clinical effect of drug balloon active protection in coronary bifurcation lesions.Methods Seventy-eight patients diagnosed with coronary artery bifurcation lesions treated at Luoding People's Hospital from January 2018 to January 2019 were randomly enrolled,and were divided into a drug balloon active protection group and an ordinary balloon active protection group by the random number method,with 39 cases in each group.All the patients received standard interventional therapy,and were followed up for 12 months after the surgery.The postoperative TIMI grading,incidences of major adverse cardiovascular events(MACE),minimal lumen diameters(MLD)of the main and branch vessels,degree of vascular stenosis,late luminal loss(LLL)of branch vessels.Results Immediately after the surgery,there were no statistical differences in the probabilities of blood flow grade TIMI 3 of the main and ranch blood vessels between the two groups(both P>0.05).During the long-term follow-up,the incidence of MACE in the drug balloon active protection group was obviously lower than that in the ordinary balloon active protection group[5.12%(2/39)vs.25.64%(10/39)],with a statistical difference(χ^(2)=6.303,P=0.012).There were no statistical differences in the main and branch vessel MLD and degrees of vascular stenosis before and immediately after the surgery and in the main vessel MLD and degrees of vascular stenosis 9 and 12months after the surgery between the two groups(all P>0.05).The branch vesselMLD and degrees of vascular stenosis 9 and 12months after the surgery were(2.30±0.20)mm,(2.20±0.18)mm,(8.05±1.31)%,and(8.23±1.46)%in the drug balloon active protection group,and were(2.12±0.22)mm,(2.03±0.15)mm,(8.92±1.35)%,and(9.22±1.40)%in the ordinary balloon active protection group,with statistical differences(all P<0.05).Twelve months after the surgery,the LLL of the branch vessels in the drug balloon active protection group was significantly lower than that in the ordinary balloon active protection group

关 键 词：介入治疗 冠状动脉分叉病变 药物涂层球囊 

分 类 号：R543.3[医药卫生—心血管疾病]