药物涂层球囊治疗冠状动脉慢性完全闭塞病变的有效性和安全性  

Efficacy and Safety of Drug-Coated Balloon in the Treatment of Coronary Chronic Total Occlusion

作　　者：刘恒道 张豫彬 刘婷 辜和平 邢军辉[1] 赵俊伟 宋瑞捧 赵妍妍 陶海龙[1] LIU Hengdao;ZHANG Yubin;LIU Ting;GU Heping;XING Junhui;ZHAO Junwei;SONG Ruipeng;ZHAO Yanyan;TAO Hailong(Department of Cardiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Cardiology,Yexian People’s Hospital,Pingdingshan 467299,China;Department of Endocrine,Henan NO.3 Provincial People’s Hospital,Zhengzhou 450007,China)

机构地区：[1]郑州大学第一附属医院心内科,河南郑州450052 [2]叶县人民医院心内科,河南平顶山467299 [3]河南省直第三人民医院内分泌科,河南郑州450007

出　　处：《河南医学研究》2025年第7期1180-1184,共5页Henan Medical Research

摘　　要：目的探讨单纯药物涂层球囊(DCB)扩张术治疗冠状动脉慢性完全闭塞病变(CTO)的有效性和安全性。方法选取2018年3月至2021年1月于郑州大学第一附属医院经冠脉造影确诊为新发CTO并接受经皮冠脉介入术(PCI)的100例患者为研究对象。根据治疗方案的不同,将患者分为药物洗脱支架(DES)(52例)治疗组和DCB(48例)治疗组。比较两组患者临床基线数据、冠脉造影数据以及主要心血管不良事件(MACE)等指标。结果DCB组和DES组的中位随访时间分别为6个月和10个月。两组患者的基线临床特征差异无统计学意义(P>0.05)。有效性分析表明,与DES组相比,DCB组患者术后即刻最小管腔直径(MLD)较小(P<0.001),直径狭窄(DS)程度较高(P<0.05)。随访期间,两组上述指标差异无统计学意义(P>0.05)。DCB组晚期管腔丢失(LLL)直径较小,差异有统计学意义(P<0.001)。术后即刻,DCB组有1例患者出现夹层,接受了支架补救性治疗;随访期间,DCB组7例(14.58%)患者发生再狭窄,DES组5例(9.62%)患者发生再狭窄,两组再狭窄率差异无统计学意义(P>0.05)。住院和随访期间,两组患者的MACE发生率差异无统计学意义(P>0.05)。Kaplan-Meier生存分析结果显示,治疗方案的选择对MACE发生风险的影响差异无统计学意义(P>0.05)。结论与DES相比,DCB治疗新发CTO病变具有相对满意的疗效和安全性,并且在晚期管腔丢失方面优于DES。因此,DCB可以作为新发CTO病变介入治疗的一种可供选择的手术策略。Objective To investigate the efficacy and safety of drug-coated balloon(DCB)dilatation in the treatment of coronary chronic total occlusion(CTO)lesions.Methods A total of 100 patients were enrolled,who were diagnosed with de novo CTO by coronary angiography and undergoing percutaneous coronary intervention(PCI)at the First Affiliated Hospital of Zhengzhou University from March 2018 to January 2021.Based on the treatment strategy,patients were divided into drug-eluting stent(DES)group(52 cases)and DCB group(48 cases).The clinical baseline data,coronary angiography data,and major adverse cardiovascular events(MACE)were compared between the two groups of patients.Results The median follow-up durations for the DCB group and the DES group were 6 months and 10 months,respectively.There were no statistical differences in baseline clinical characteristics between the two groups.Efficacy analysis revealed that compared to the DES group,the DCB group had a smaller minimum lumen diameter(MLD)immediately after the procedure(P<0.001)and a higher degree of diameter stenosis(DS)(P<0.05).During follow-up,there were no statistical differences in these parameters between the two groups(P>0.05).The DCB group exhibited a smaller late lumen loss(LLL)diameter,with a statistical difference(P<0.001).Immediately after the procedure,one patient in the DCB group occurred dissection and underwent salvage stent therapy.During follow-up,7 patients(14.58%)in the DCB group experienced restenosis,while 5 patients(9.62%)in the DES group experienced restenosis,and there was no statistical difference in restenosis rate between the two groups(P>0.05).There were also no statistical differences in MACE rates between the two groups during hospitalization and follow-up(P>0.05).Kaplan-Meier survival analysis demonstrated that the choice of treatment strategy had no statistically significant impact on the risk of MACE(P>0.05).Conclusion Compared to DES,DCB demonstrates relatively satisfactory efficacy and safety in treating de novo CTO lesions and is sign

关 键 词：冠状动脉慢性完全闭塞病变 经皮冠脉介入术 药物涂层球囊扩张术 药物洗脱支架植入术 

分 类 号：R543.3[医药卫生—心血管疾病]