药物涂层球囊与药物洗脱支架对冠状动脉原位病变患者新生内膜增生影响分析  

Effect of Drug-Coated Balloon and Drug-Eluting Stent on Neointimal Hyperplasia in Patients with Coronary Artery in Situ Lesions

作　　者：李晨阳 袁百祥 徐晶晶 张桂娟 LI Chenyang;YUAN Baixiang;XU Jingjing;ZHANG Guijuan(Tangshan Hongci Hospital,Tangshan,Hebei,China 063000)

机构地区：[1]唐山弘慈医院,河北唐山063000

出　　处：《中国药业》2023年第19期118-121,共4页China Pharmaceuticals

基　　金：中国金属学会冶金安全与健康分会健康卫生科研项目[jkws201810]。

摘　　要：目的 探讨血管内超声(IVUS)引导下药物涂层球囊(DCB)和药物洗脱支架(DES)治疗冠状动脉原位病变的效果,以及对患者术后新生内膜增生的影响。方法 选取医院2020年1月至2022年1月收治的冠状动脉原位病变患者122例,根据治疗方法的不同分为DCB组(58例,行IVUS引导下DCB治疗)和DES组(64例,行IVUS引导下DES治疗)。两组患者均随访6个月。结果 两组患者术后即刻的最小管腔面积(LA_(min))、平均管腔面积(LA_(mean))均显著升高(P <0.05),斑块负荷(PB)均显著降低(P <0.05),且DCB组均显著优于DES组(P <0.05)。随访6个月后,两组患者的最大新生内膜厚度(NT_(max))均显著高于术后即刻(P <0.05),且DCB组患者的NT_(max)和最大新生内膜面积(NA_(max))均显著低于DES组(P <0.05);DCB组和DES组患者的主要心血管不良事件发生率相当(3.45%比9.38%,P> 0.05)。DCB组患者边支的晚期管腔丢失(LLL)直径显著低于DES组(P <0.05);DCB组的冠状动脉再狭窄率为6.90%,显著低于DES组的32.81%(P <0.05)。结论 IVUS引导下DCB治疗冠状动脉原位病变的效果较DES更佳,有助于减少患者的新生内膜增生,且介入治疗的安全性良好。Objective To investigate the efficacy of intravascular ultrasound(IVUS)-guided drug-coated balloon(DCB)and drug-eluting stent(DES)in the treatment of coronary artery in situ lesions,and its effect on postoperative neointimal hyperplasia in patients.Methods A total of 122 patients with coronary artery in situ lesions admitted to the hospital from January 2020 to January 2022 were selected and divided into the DCB group(58 cases,receiving IVUS-guided DCB treatment)and the DES group(64 cases,receiving IVUS-guided DES treatment)based on different treatment methods.Both groups were followed up for six months.Results The minimum lumen area(LAmin)and mean lumen area(LAmean)immediately after surgery in the two groups significantly increased,while the plaque burden(PB)immediately after surgery in the two groups significantly decreased(P<0.05),and those in the DCB group were significantly better than those in the DES group(P<0.05).After six months of follow-up,the maximum neointimal thickness(NTmax)in the two groups was significantly higher than that immediately after surgery(P<0.05),while the NTmax and maximum neointimal area(NAmax)in the DCB group were significantly lower than those in the DES group(P<0.05);the incidence of major cardiovascular adverse events(MACE)in the DCB group was comparable to that in the DES group(3.45%vs.9.38%,P>0.05).The diameter of late lumen loss(LLL)in the DCB group was significantly shorter than that in the DES group(P<0.05).The incidence of coronary artery restenosis in the DCB group was 6.90%,which was significantly lower than 32.81%in the DES group(P<0.05).Conclusion IVUS-guided DCB in the treatment of coronary artery in situ lesions has a better effect than DES,which helps to reduce neointimal hyperplasia in patients,and ensures the safety of interventional therapy.

关 键 词：血管内超声 药物涂层球囊 药物洗脱支架 冠状动脉 原位病变 新生内膜 

分 类 号：R969.4[医药卫生—药理学] R972[医药卫生—药学]