经皮冠状动脉腔内冲击波球囊导管成形术预处理冠状动脉重度钙化的有效性及安全性  

Effectiveness and Safety of Coronary Intravascular Lithotripsy for Pretreating Severe Coronary Artery Calcification

作　　者：贵双俊 周程昊 李昱瑾 白保强 刘士超[2] GUI Shuangjun;ZHOU Chenghao;LI Yujin;BAI Baoqiang;LIU Shichao(Department of Cardiovascular Medicine,Zhumadian Central Hospital,Zhumadian 463000,China;Department of Cardiovascular Medicine,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]河南省驻马店市中心医院心内科,463000 [2]郑州大学第二附属医院心内科,河南省郑州市450003

出　　处：《实用心脑肺血管病杂志》2025年第2期109-112,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210382)。

摘　　要：目的探讨经皮冠状动脉腔内冲击波球囊导管成形术(IVL)预处理冠状动脉重度钙化的有效性及安全性。方法回顾性选取2022年12月—2024年6月于驻马店市中心医院心内科行经皮冠状动脉介入治疗(PCI)的冠状动脉重度钙化患者85例作为研究对象,根据PCI中预处理方法将患者分为IVL组(n=42)和非IVL组(n=43)。比较两组手术指标及术前、术后3个月炎症指标(hs-CRP、IL-6、TNF-α)、心肌酶谱指标〔心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、肌红蛋白(Mb)〕,并观察两组不良事件发生情况。结果IVL组最狭窄处管腔面积增加率、支架膨胀率、钙化环打开率高于非IVL组,手术时间短于非IVL组(P<0.05)。术前及术后3个月,两组hs-CRP、IL-6、TNF-α、cTnI、CK-MB、Mb比较,差异无统计学意义(P>0.05)。两组均未发生血栓形成、血管急性闭塞,其中非IVL组出现血管夹层3例,发生率为7.0%。结论IVL预处理冠状动脉重度钙化可提高最狭窄处管腔面积增加率、支架膨胀率、钙化环打开率,利于缩短手术时间,且安全性较高。Objective To investigate the effectiveness and safety of coronary intravascular lithotripsy(IVL)for pretreating severe coronary artery calcification.Methods A total of 85 patients with severe coronary artery calcification who underwent percutaneous coronary intervention(PCI)in the Department of Cardiovascular Medicine,Zhumadian Central Hospital from December 2022 to June 2024 were selected as the study subjects.According to pretreatment methods in PCI,they were divided into the IVL group(n=42)and the non-IVL group(n=43).Surgical indexes,inflammatory indexes(hs-CRP,IL-6,TNF-α)and myocardial zymogram indexes[cardiac troponin I(cTnI),creatine kinase isoenzyme(CK-MB),myoglobin(Mb)]before operation and at 3 months after operation were compared between the two groups,and the adverse events of the two groups were observed.Results The increase rate of area,stent expansion rate and calcification ring opening rate of lumen at the narrowest part in the IVL group were higher than those in the non-IVL group,surgical time in the IVL group was shorter than that in the non-IVL group(P<0.05).Before operation and at 3 months after operation,there was no significant difference in hs-CRP,IL-6,TNF-α,cTnI,CK-MB,Mb between the two groups(P>0.05).There was no thrombosis or acute vascular occlusion in the two groups,there were 3 cases of vascular dissection in the non-IVL group,with an incidence of 7.0%.Conclusion IVL can improve the increase rate of area,stent expansion rate and calcification ring opening rate of lumen at the narrowest part in the pretreatment of severe coronary artery calcification,which is beneficial to shorten the operation time,and with higher safety.

关 键 词：血管钙化 冠状动脉重度钙化 经皮冠状动脉内冲击波球囊导管成形术 预处理 

分 类 号：R561.2[医药卫生—呼吸系统]