药物涂层球囊在血液透析动静脉血管通路的疗效分析  

Efficacy of drug-coated balloon in the treatment of venous stenosis in hemodialysis access

作　　者：霍桂军 曾宇琪 陶志红 张琴 姚志超 周大勇[1] HUO Gui-jun;ZENG Yu-qi;TAO Zhi-hong;ZHANG qin;YAO Zhi-chao;ZHOU Da-yong(Department of Vascular Surgery,Suzhou Hospital Affiliated to Nanjing Medical University/Suzhou Municipal Hospital(Main Campus),Suzhou 215000,China)

机构地区：[1]南京医科大学附属苏州医院/苏州市立医院(本部)血管外科,苏州215000

出　　处：《中国血液净化》2024年第6期457-461,共5页Chinese Journal of Blood Purification

基　　金：苏州市“科教兴卫”青年科技项目(KJXW2021031)。

摘　　要：目的评价药物涂层球囊血管成形术(drug-coated balloon angioplasty,DCBA)和普通球囊血管成形术(conventional balloon angioplasty,CBA)治疗动静脉内瘘(arteriovenous fistula,AVF)狭窄的安全性与疗效。方法回顾性分析2020年11月─2022年4月在苏州市立医院(本部)收治的152例AVF狭窄的血液透析患者临床资料,根据治疗方式分为药物涂层球囊(drug-coated balloon,DCB)组(n=62)和普通球囊(conventional balloon,CB)组(n=90),采用Kaplan-Meier曲线评估2组靶病变再狭窄发生率,并比较手术后6个月的靶病变初级通畅率(target lesion primary patency,TLPP)。结果所有患者均取得了技术成功和临床成功并完成随访;Kaplan-Meier生存分析曲线及Log-rank检验结果显示6个月时DCB组初级通畅率优于CB组(OR=1.935,95%CI:1.173~3.193,P=0.017)。结论研究结果表明:相较于CBA而言,DCBA可以明显提高血液透析患者AVF的初级通畅率,减少靶病变的再干预,对于AVF狭窄是一种有效安全的治疗方式。Objective To compare the safety and efficacy of drug-coated balloon angioplasty(DCBA)and conventional balloon angioplasty(CBA)in the treatment of venous stenosis in arteriovenous fistula(AVF)for hemodialysis access.Methods A retrospective analysis was conducted on the clinical data of 152 hemodialysis patients with AVF stenosis and treated at Suzhou Municipal Hospital from November 2020 to April 2022.Based on the treatment method,they were divided into the drug-coated balloon(DCB)group(n=62)and the conventional balloon(CB)group(n=90).Kaplan-Meier curve was used to assess re-stenosis rate of the target lesion in both groups.Primary patency of the target lesion(TLPP)was compared after the operation for 6 months.Results All patients achieved technical and clinical success,and completed follow-up observation.There were no statistical differences in baseline characteristics between the two groups(P>0.05).Kaplan-Meier survival analysis and log-rank test indicated that DCBA significantly prolonged the patency of AVF.TLPP after 6 months showed that the DCB group had higher patency rate compared to the CB group(OR=1.935,95%CI:1.173~3.193,P=0.017).Conclusion Our research results indicate that DCBA improves the primary patency rate of AVFs better than CBA in hemodialysis patients,and DCBA also reduces the need for re-intervention of the target lesion.Therefore,DCBA is an effective and safe method for treatment of AVF stenosis.

关 键 词：药物涂层球囊 普通球囊 动静脉内瘘狭窄 血管通路 血液透析 

分 类 号：R318.16[医药卫生—生物医学工程]