球囊支架对吻术与拘禁导丝保护技术治疗老年冠状动脉分叉病变的临床疗效  

Clinical efficacy of balloon stent kissing technique and jailed wire technique in treatment of coronary bifurcation lesions in the elderly

作　　者：杨可 彭艳 杨颖 赵刚 Yang Ke;Peng Yan;Yang Ying;Zhao Gang(Department of Cardiology,University Town Hospital Affiliated to Chongqing Medical University,Chongqing 401331,China)

机构地区：[1]重庆医科大学附属大学城医院心血管内科,重庆401331

出　　处：《中华老年多器官疾病杂志》2024年第7期496-499,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：重庆市科卫联合医学科研项目重点项目(2020GDRC024)。

摘　　要：目的探讨球囊支架对吻术(BSKT)与拘禁导丝保护技术(JWT)两种介入方式治疗老年冠状动脉分叉病变(CBL)的临床疗效。方法回顾性分析2019年8月至2021年4月在重庆医科大学附属大学城医院进行治疗的124例老年CBL患者的临床资料。将采用JWT介入治疗者纳入对照组(n=64),采用BSKT介入治疗者纳入观察组(n=60)。采用SPSS 20.0统计软件进行数据分析,并采用t检验进行组间比较。结果术后6个月,两组患者主支血管最小内径(MLD)均升高,狭窄程度、直径狭窄率(DS)及病变长度均降低,差异有统计学意义(P<0.05);但组间MLD、狭窄程度、DS及病变长度比较,差异无统计学意义(P>0.05)。术后6个月,两组分支血管MLD均升高,狭窄程度、DS及病变长度均降低;观察组术后6个月分支MLD明显高于对照组,狭窄程度、DS及病变长度均低于对照组;术后72 h观察组超敏肌钙蛋白I(hs-cTnI)、超敏C反应蛋白(hs-CRP)及脂蛋白相关磷脂酶A2(LP-PLA2)水平均显著低于对照组;术后72 h观察组血管紧张素Ⅱ(AngⅡ)、血管性血友病因子(vWF)水平均明显低于对照组,差异均有统计学意义(P<0.05)。结论与JWT比较,BSKT介入方式在老年CBL患者中应用更佳,可有效减少患者心肌功能损伤及内皮功能损伤,对分支血管具有良好的保护作用,值得推广。Objective To investigate the clinical efficacy of interventional therapy with balloon stent kissing technique(BSKT)and jailed wire technique(JWT)for coronary bifurcation lesions(CBL)in the elderly.Methods A retrospective analysis was conducted on 124 elderly CBL patients treated in our hospital from August 2019 to April 2021.Their clinical data were collected and analyzed,and those receiving JWT interventional therapy were assigned into the control group(n=64),while those undergoing BSKT interventional therapy were included in the observation group(n=60).SPSS statistics 20.0 was used for data analysis,student′s t test was employed for intergroup comparison.Results In 6 months after operation,the minimum lumen diameter(MLD)of the main vessel was increased,and the stenosis,diameter stenosis rate(DS)and lesion length were decreased in both groups(P<0.05),but there were no significant differences in the above four indicators between the two groups(P>0.05).For the branch vessels,the MLD was increased,and the stenosis,DS and lesion length were decreased in 6 months after surgery in both groups(P<0.05).The MLD of branch vessels was significantly higher,and the stenosis,DS and lesion length were lower in the observation group than the control group(P<0.05).In 72 h after surgery,the levels of high-sensitivity cardiac troponin I(hs-cTnI),high-sensitivity C-reactive protein(hs-CRP)and lipoprotein-associated phospholipase A2(LP-PLA2)were significantly lower,while those of angiotensinⅡ(AngⅡ)and von Willebrand factor(vWF)were significantly lower in observation group than the control group(P<0.05).Conclusion BSKT interventional therapy is superior to JWT in treatment of CBL in the elderly patients,with the advantages of effectively reducing the myocardial function injury and endothelial function injury,and exerting a good protective effect on branch blood vessels,and therefore,it is worthy of promotion in clinical practice.

关 键 词：老年人 球囊支架对吻术 拘禁导丝保护技术 介入治疗 冠状动脉分叉病变 

分 类 号：R543.3[医药卫生—心血管疾病]