后扩张对老年冠状动脉钙化病变介入治疗的疗效观察

Observation on therapeutic effects of postdilatation for elderly patients with coronary artery calcification lesion

目的:观察后扩张应用于老年冠状动脉钙化病变经皮冠状动脉介入治疗(Percutaneous Coronary Inter-vention,PCI)的临床疗效。方法:血管造影成功的老年钙化病变冠心病患者107例随机分组,对照组52例行常规支架球囊释放支架术,后扩张组55例于支架常规释放后以非顺应性球囊行高压后扩张,观察两组术中并发症发生率及术后1周、1个月6、个月支架内血栓、再狭窄和主要不良心脏事件(MACE)发生率。结果:后扩张组和对照组PCI术中并发症差异无统计学意义(P>0.05),后扩张组管腔内径获得明显大于对照组(P<0.05)6,个月时后扩张组管腔内径丢失明显小于对照组(P<0.05),靶病变最小内径后扩张组大于对照组(P<0.05),差异均有统计学意义;后扩张组支架内血栓、再狭窄率、心血管不良事件较对照组均明显减少(P<0.05),差异有统计学意义。结论:老年冠脉钙化病变患者PCI术中常规球囊后扩张治疗安全可行,能够降低支架内血栓、再狭窄和主要不良心脏事件发生率。

Objective：To observe the clinical therapeutic effect of adjunctive balloon postdilatation applying to percutaneous coronary intervention for elderly patients with coronary artery calcification lesion. Methods：After angiographic,107 elderly patients with coronary artery calcification lesion hospitalized in our hospital were randomly divided into two groups by PCI approach which 52 cases were conventional deployment（CD） group and 55 cases were post-dilatation deployment（PD） group.Observe complications incidence of intraoperative and stent thrombosis,stent restenosis and major adverse cardiac events（MACE） within one week,one month and six months in tow groups. Results：There were no significant differences in PCI intraoperative complications between the two groups（P0.05）.The absolute luminal diameter gain after PCI in PD group were 1arger than those in CD group（P0.05）.Six months later,the luminal diameter loss in PD group were 1ower than those in CD group（P0.05）.The luminal minimal diameters in PD group were lager than that in CD group（P0.05）.The differences were significant.Stent thrombosis,restenosis rate and cardiovascular adverse events in PD group were significantly reduced compared with control group（P0.05）,the differences were significant. Conclusion：Post-dilatation is safe and effective after drug-eluting stent deployment for elderly patients with coronary artery calcification lesion.It can reduce stent thrombosis,the in-stent restenosis rate and major adverse cardiac events.