药物涂层球囊在冠状动脉小血管病变中的疗效

Analysis of the curative effect of drug-coated balloon in small coronary vessels

目的分析药物涂层球囊(DCB)在冠状动脉小血管病变应用中的有效性及安全性。方法入选2016年2月至2018年2月我院冠心病小血管病变患者65例,随机分为DCB组、药物洗脱支架(DES)组,分别采用DCB和DES治疗,6个月后复查造影,比较两组靶病变最小管腔直径(MLD)、晚期管腔丢失(LLL)、主要不良心血管事件(MACE)发生率。结果 DCB组33例患者共36处接受DCB治疗,DES组32例共35处接受DES治疗,两组手术成功率(94.4%vs. 94.3%,P=0.69),术后即刻MLD(1.62±0.38)mm vs.(2.06±0.24)mm,P <0.001。术后6个月DCB组25例、DES组24例复查造影,两组LLL(0.06±0.43)mm vs.(0.37±0.47)mm,P=0.03,心肌梗死、靶血管再次血运重建、心源性死亡、MACE分别为(3.0%vs.6.3%;6.1%vs. 15.6%;3.0%vs. 3.1%;12.5%vs. 21.9%),差异均无统计学意义(P <0.05)。结论 DCB可减少冠状动脉小血管病变LLL,MACE发生率与DES相似,应用前景良好。

Objective To evaluate the efficacy and safety of drug coated balloon(DCB)in the treatment of small coronary vessels.Methods 65 patients with small coronary vessels in our hospital from February 2016 to February 2018 were selected and randomly divided into DCB group and DES group.Patients in the two groups were treated with DCB and DES respectively.Six months later,angiography was performed to compare the incidence of minimal lumen diameter(MLD),advanced lumen loss(LLL),and major adverse cardiovascular events(MACE)between the two groups.Results A total of 33 patients(36 lesions)were implanted with DCB and 32 patients(35 lesions)were implanted with DES,The surgical success rate(94.4%vs.94.3%,P=0.69),postoperative immedi ate MLD[(1.62±0.38)mm vs.(2.06±0.24)mm,P<0.001].Six months after surgery,25 patients in the DCB group and 24 patients in the DES group underwent angiography.The LLL[(0.06±0.43)mm vs.(0.37±0.47)mm,P=0.03],myocardial infarction,target lesion revascularization,cardiac death,MACE,respectively(3.0%vs.6.3%;6.1%vs.15.6%;3.0%vs.3.1%;12.5%vs.21.9%).The differences were not statistically significant.Conclusion DCB can reduce LLL in small coronary vessels,and MACE similar to DES,showing a good applica tion prospect.