药物涂层球囊、药物洗脱支架在冠状动脉原位弥漫性长病变治疗中的应用对比观察  

Comparative observation of drug-coated balloon and drug-eluting stent in the treatment of de-novo diffuse long coronary lesions

作　　者：周世龙 王喜甲 白雪洋[1] 韩旭飞 李中根 李凌[1] ZHOU Shilong;WANG Xijia;BAI Xueyang;HAN Xufei;LI Zhonggen;LI Ling(Department of Cardiology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院心内科,郑州450052

出　　处：《山东医药》2022年第33期13-17,共5页Shandong Medical Journal

摘　　要：目的对比观察药物涂层球囊(DCB)、药物洗脱支架(DES)在冠状动脉原位弥漫性长病变治疗中的应用效果。方法接受PCI术治疗的冠状动脉原位弥漫性长病变患者202例,依据介入策略的不同,分为DCB组(68例患者,共72处病变)和DES组(134例患者,共142处病变)。DCB组患者在PCI术中应用DCB治疗,DES组患者在PCI术中应用DES治疗,观察两组术后即刻最小管腔直径(MLD)、术后即刻狭窄程度、术后即刻管腔获得。术后6~12个月内进行冠状动脉造影随访,观察随访时MLD、随访时狭窄程度、晚期管腔丢失、净管腔获得。观察两组术后12个月时并发症发生情况,包括靶病变再狭窄、靶病变血运重建(TLR)、非致死性心肌梗死、全因死亡等。结果DCB组术后即刻MLD、术后即刻管腔获得均低于DES组(P均<0.05),DCB组术后即刻狭窄程度高于DES组(P<0.05)。DCB组术后冠状动脉造影随访时晚期管腔丢失低于DES组(P<0.05)。两组术后12个月时靶病变再狭窄、TLR、非致死性心肌梗死、全因死亡等并发症相比,P均>0.05。结论PCI术中应用DCB、DES治疗冠状动脉原位弥漫性长病变,DES术后即刻疗效优于DCB,但DCB术后晚期管腔丢失更少。Objective To compare and observe the effects of drug-coated balloon(DCB)and drug-eluting stent(DES)in the treatment of de-novo diffuse long coronary lesions.Methods Totally 202 patients with de-novo diffuse long coronary lesions who underwent PCI were divided into the DCB group(68 patients with 72 lesions)and DES group(134 patients with 142 lesions)according to interventional strategy.Patients in the DCB group were treated with DCB only and patients in the DES group were treated with DES only.The differences between the two groups in terms of the immediate postoperative minimum lumen diameter(MLD),stenosis degree and lumen gain were observed.Coronary angiography follow-up was performed within 6 to 12 months after PCI.We observed MLD,stenosis degree,late lumen loss,and net lumen gain at follow-up.The complications of the two groups at 12 months after PCI were also observed,including target lesion restenosis,target lesion revascularization(TLR),nonfatal myocardial infarction,and all-cause death.Results The immediate postoperative MLD and lumen gain in the DCB group were lower than those in the DES group(all P<0.05),and the immediate postoperative stenosis degree was higher in the DCB group(P<0.05).The late lumen loss at follow-up in the DCB group was lower than in the DES group(P<0.05).No significant differences were found in the rates of target lesion restenosis,TLR,nonfatal myocardial infarction,and all-cause death between two groups(all P>0.05).Conclusion The immediate postoperative efficacy of DES was better than that of DCB in the treatment of de-novo diffuse long coronary lesions,but the late lumen loss of DCB was less.

关 键 词：经皮冠状动脉介入治疗 药物涂层球囊 药物洗脱支架 冠状动脉原位弥漫性长病变 

分 类 号：R541.4[医药卫生—心血管疾病]