药物涂层球囊治疗支架内再狭窄和原位病变的远期预后分析  

Long-term follow-up after treatment of drug-eluting stent restenosis and de novo lesions

作　　者：张黛 孙岩[1] 程宇婧 马晓腾 刘晓丽[1] 赵迎新[1] 周玉杰[1] ZHANG Dai;SUN Yan;CHENG Yujing;MA Xiaoteng;LIU Xiaoli;ZHAO Yingxin;ZHOU Yujie(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart Lung and Blood Vessel Disease,The Key Laboratory of Remodeling-related Cardiovascular Disease,Ministry of Education,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所冠心病精准治疗北京市重点实验室,首都医科大学冠心病临床诊疗与研究中心心内科,100029

出　　处：《心肺血管病杂志》2022年第3期221-226,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家重点研发计划“精准医学研究”重点专项(2017YFC0908800);首都卫生发展科研专项(首发2020-2-2063);北京市教育委员会科技计划(KM201910025012);北京市自然科学基金(7202041)。

摘　　要：目的:评估药物涂层球囊(DEB)治疗对支架内再狭窄(DES-ISR)和原位病变患者远期靶病变血运重建(TLR)和主要心脑血管不良事件(MACEs)发生的影响。方法:本研究严格按照研究设计的入选与排除标准,纳入应用DEB治疗DES-ISR(n=174)及原位病变(n=64)的238例患者。比较两组患者临床资料、造影结果、患者术后1年及长期随访结果。结果:在术后1年随访结果中,总入选患者的TLR和MACEs发生率均较低(分别为5.0%和6.3%)。在长期随访结果中,两组间的TLR发生率差异有统计学意义(14.4%vs.3.1%,P=0.028);ISR组MACEs的发生率明显增加(21.8%vs.6.2%,P=0.009)。ISR组的长期预后略差(TLR,log-rank P=0.019;MACEs,log-rank P=0.010)。结论:DES-ISR及原位病变患者的TLR及MACEs发生率均较低,在一定程度上证实DEB治疗策略是有效且安全的。Objective:We investigated the effect of drug-eluting stent(DEB)on procedural complications,target lesion revascularization(TLR),and major adverse cardiac and cerebrovascular events in patients with DES-ISR and de novo lesions.Methods:The clinical profiles of 238 consecutive patients treated for coronary ISR(n=174)and de novo lesions(n=64)using SeQuent Please paclitaxel-coated balloon(PCB)were analyzed.Study endpoints were major adverse cardiac events(MACEs).Results:At 1-year follow-up,TLR and MACEs occurred with acceptably low rates(5.0 and 6.3%,respectively).At 2.00±0.74-year follow-up,there was a significant difference in the rates of TLR between the ISR and the de novo lesions groups(14.4%vs.3.1%,P=0.028),and the occurrence of MACEs distinctly increased in the ISR group compared with the de novo lesions group(21.8%vs.6.2%,P=0.009).The long-term outcomes of the ISR group were inferior to those of the de novo group(TLR,log-rank P=0.019;MACEs,log-rank P=0.010).Conclusions:DEB for ISR and de novo lesions of small coronary vessels is effective and safe.

关 键 词：支架内再狭窄 原位病变 药物涂层球囊 靶病变血运重建 

分 类 号：R54[医药卫生—心血管疾病]