金属裸支架及药物洗脱球囊对股-腘动脉闭塞性动脉硬化二次治疗的疗效分析

Effect of bare metal stent and drug-eluting balloon on ankle brachial index and plasma homocysteine level in patients with femoral-popliteal atherosclerotic occlusion after secondary treatment

目的探讨金属裸支架及药物洗脱球囊对股-腘动脉闭塞性动脉硬化二次治疗的疗效。方法收集2017年8月至2020年8月在北京市海淀医院接受二次治疗的128例股-腘动脉闭塞性动脉硬化患者的临床资料,根据治疗方式不同分为金属裸支架组(n=58)和药物洗脱球囊组(n=70)。术前与术后3个月,统计两组患者实验室指标[甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、同型半胱氨酸(Hcy)水平]、踝肱指数、Rutherford分级;统计出院时患者满意率及术后3个月患肢通畅情况和不良事件发生情况。结果术后3个月,药物洗脱球囊组患者踝肱指数高于金属裸支架组,Rutherford分级和Hcy水平低于金属裸支架组,差异有统计学意义(P<0.05);两组患者的TG水平、TC水平、LDL水平、不良事件发生率和术后通畅率比较,差异无统计学意义(P>0.05)。出院时,药物洗脱球囊组患者满意率高于金属裸支架组患者,差异有统计学意义(P<0.05)。结论金属裸支架和药物洗脱球囊对股-腘动脉闭塞性动脉硬化二次治疗均有一定疗效,但药物洗脱球囊在改善踝肱指数和Hcy水平优于金属裸支架组,且患者满意率更高。

Objective To observe the therapeutic effect of bare metal stent(BMS)and drug-eluting balloon(DCB)on secondary treatment of femoral-popliteal atherosclerotic occlusion.Method The clinical data of 128 patients with femoral-popliteal atherosclerotic occlusion who underwent secondary treatment in Beijing Haidian Hospital from August 2017 to August 2020 were retrospectively analyzed.According to the different treatment regimens,they were divided into BMS group(n=58)and DCB group(n=70).Before operation and 3 months after operation,the laboratory indexes[triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL),homocysteine(Hcy)levels],ankle brachial index and Rutherford grade of the two groups were statistically analyzed.The satisfaction rate of patients at discharge,patency of affected limbs and occurrence of adverse events at 3 months after operation were analyzed.Result At 3 months after operation,the ankle brachial index of DCB group was higher than that of BMS group,Rutherford grade and Hcy level were lower than those of BMS group,the difference was statistically significant(P<0.05).There was no significant difference in TG,TC,LDL levels,incidence of adverse events and postoperative patency rate between the two groups(P>0.05).At discharge,the satisfaction rate of DCB group was higher than that of BMS group,the difference was statistically significant(P<0.05).Conclusion BMS and DCB have certain therapeutic effect on femoral popliteal atherosclerotic occlusive disease,but DCB is better than BMS in improving ankle brachial index and Hcy.