药物涂层球囊治疗冠状动脉支架内再狭窄的临床价值  

Clinical value of drug⁃coated balloons in treating in⁃stent restenosis

作　　者：吴玲娟 米增杰 洪莉莉 Wu Lingjuan;Mi Zengjie;Hong Lili(Department of Cardiovasology,Nantong Haimen People’s Hospital,Nantong 226101,China)

机构地区：[1]南通市海门区人民医院心血管内科,江苏南通226101

出　　处：《海军医学杂志》2023年第11期1158-1162,共5页Journal of Navy Medicine

摘　　要：目的探讨药物涂层球囊(DCB)治疗冠状动脉支架内再狭窄(ISR)的临床价值。方法选取2018年1月至2021年10月南通市海门区人民医院心血管内科收治的80例ISR患者,依据数字表法随机分为观察组(n=40)和对照组(n=40),观察组应用DCB治疗支架内再狭窄病变,对照组应用药物洗脱支架(DES)治疗,分析并比较2组患者术前、术后即刻靶病变管腔直径及狭窄率、术中冠状动脉夹层发生率,随访术后12个月内主要不良心血管事件(MACEs)及支架内再狭窄发生情况。结果2组患者临床资料间差异无统计学意义(P>0.05)。治疗前2组靶血管病变管腔直径、狭窄率差异无统计学意义;治疗后,2组患者靶血管管腔直径、狭窄率明显改善,且观察组改善情况优于对照组(P<0.05),但2组冠状动脉夹层发生率差异无统计学意义。复查观察组靶病变管腔直径大于对照组,且管腔狭窄率及再发ISP率低于对照组(P<0.05)。观察组总MACEs发生率低于对照组,无事件生存时间长于对照组(P<0.05)。结论药物涂层球囊能够改善ISR治疗效果,且临床安全性高,可降低远期不良事件发生率,具有较高的临床应用价值。Objective To investigate the clinical value of drug‑coated balloon(DCB)in the treatment of in‑stent restenosis(ISR).Methods A total of 80 patients with ISR admitted to the Department of Cardiovasology of Nantong Haimen People’s Hospital from January 2018 to October 2021 were enrolled and assigned to observation group(n=40)or control group(n=40)according to the random number table method.DCB was applied in the observation group and drug‑eluting stent(DES)was used in the control group.The lumen diameter and stenosis rate of target vessels before surgery and immediately after surgery,intraoperative incidence of coronary artery dissection,and the occurrence of major adverse cardiovascular events(MACEs)and ISR within 12 months after surgery were compared between the two groups.Results There were no significant differences in clinical data between the two groups(P>0.05).There were no significant differences in the lumen diameter or stenosis rate of target vessels before treatment between the two groups.After treatment,the lumen diameter and the stenosis rate of target vessels were significantly improved in both groups,and the improvement in the observation group was superior to the control group(P<0.05).But there was no significant difference in the incidence of coronary artery dissection between the two groups.The lumen diameter of the target vessels by re‑examination coronary angiography in the observation group was significantly higher than that in the control group,while the stenosis rate of the re‑examination target lesion and the incidence of recurrent ISR in the observation group were significantly lower than those in the control group(P<0.05).The total incidence of MACEs in the observation group was significantly lower than that in the control group,and the event‑free survival time in the observation group was significantly longer than that in the control group(P<0.05).Conclusion DCB can improve the treatment effect of ISR and reduce long‑term adverse events.It has high clinical safety and high

关 键 词：冠心病 支架内再狭窄 药物涂层球囊 药物涂层支架 主要不良心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]