药物洗脱支架植入与球囊扩张治疗膝下动脉病变的临床效果

Clinical effect of drug-eluting stents implantation and balloon expansion in treatment of patients with knee artery lesions

目的比较药物洗脱支架植入与单纯球囊扩张治疗膝下动脉病变的临床效果。方法68例膝下动脉病变患者按照随机原则分为对照组和观察组，每组各34例。对照组给予单纯球囊扩张治疗，观察组在球囊扩张基础上植入药物涂层裸支架。比较两组患者治疗前及治疗后6个月和12个月病变部位的皮温、经皮氧分压（TcPO：）、踝肱指数（ABI）以及复发率。结果术后6个月观察组TcPO2[（35．4±4．5）mmHg]及ABI（0．85±0．04）明显高于对照组[（28．2±3．5）mmHg、0．62±0．03]，差异均有统计学意义（t值分别为2．535、2．185，P均〈0．05）；术后12个月观察组患者皮温[（32．4±4．3）℃]、TcPO：[（34．3±4．2）mmHg]及ABI（0．80±0．04）均明显高于对照组[（28．6±3．7）℃、（26．4±3．6）mmHg、0．53±0．02]，差异均有统计学意义（t值分别为2．354、2．648、2．064，P均〈0．05）。观察组复发率（5．9％）明显低于对照组（32．4％），差异有统计学意义（X2=8．463，P〈0．05）。结论药物洗脱支架植入治疗膝下动脉病变临床效果优于单纯应用球囊扩张。

Objective To compare the clinical effect of drug-eluting stents implantation or pure balloon expansion for the treatment of patients with knee artery lesions. Methods Sixty-eight patients with knee artery lesions were randomly and voluntarily divided into the control group （ n = 34 ） and observation group （ n = 34 ）. The patients in the control group were given balloon expansion treatment, while in observation group were implanted drug-eluting stents besides balloon expansion. Pathological changes of skin temperature, percutaneous oxygen partial pressure （TcPO2 ）, ankle brachial index（ ABI）, and the recurrence rate of patients before and after treatment for 6 months and 12 months were recorded and compared. Results After 6 months treatment, TcPO2 and ABI in observation group were （ 35.4±4. 5 ） mmHg and 0. 85 ± 0. 04, significantly higher than that in control group （ （ 28. 2 ± 3.5 ） mmHg and 0. 62 ±0. 03 ） , and the differences were statistically significant （ t = 2. 535,2. 185 ;P 〈 0. 05 ）. At 12 months after treatment, skin temperature, TcPO2, ABI in observation group were （ 32. 4 ± 4. 3 ） ℃, （ 34. 3 ±4. 2 ） mmHg and 0. 80 ± 0.04, significantly higher than that of the control group （ （28.6± 3.7 ）℃, （ 26. 4± 3.6 ） mmHg, 0. 53 ±0. 02 ; t = 2. 354,2. 648,2. 064 ; P 〈 0. 05 ）. Meanwhile, the 2 recurrence rate was 5.9% in observation group, significantly lower than that of the control group （ 32.4% ; X = 8. 463,P 〈 0. 05 ）. Conclusion The clinical effect of drug-eluting stents implantation in treatment of patients with knee artery lesions is superior to that of balloon expansion.