药物涂层球囊在冠状动脉小血管原发病变的临床效果评价

Clinical evaluation of drug coated balloon in small vessel disease of coronary arteries

目的:评价药物涂层球囊对冠状动脉小血管原发病变(SVD)的临床效果。方法:前瞻性选取2017年1月至2017年12月,我院收治的SVD患者166例作为研究对象,分为药物洗脱支架(DES)组78例和药物涂层球囊(DCB)组88例,观察两组治疗效果、血管再狭窄(ISR)和不良事件。结果:DCB组治疗后最窄直径、病变长度和直径狭窄率均较治疗前明显改善(DCB组:t=32.963、3.420、28.346;DES组:t=17.613、2.089、9.862,P<0.05);DCB组治疗后最窄直径、病变长度和直径狭窄率改善情况均优于DES组(t=7.672、2.593、8.619,P<0.05)。至随访结束时,两组均有部分病例出现病变血管ISR,其中DES组进展比例高于DCB组(χ^2=34.901,P<0.05),而维持、好转比例低于DCB组(χ^2=18.769、8.448,P<0.05);DES组不良事件发生率(25.6%)高于DCB组(14.8%),但组间比较差异无统计学意义(χ^2=3.067,P>0.05)。结论:DCB治疗冠状动脉SVD的临床疗效优于DES,同时降低远期ISR,不良事件无显著增加。

Objective:To evaluate the clinical effect of drug-coated balloon on small vessel disease(SVD)of coronary arteries.Methods:From January 2017 to December 2017,166 SVD patients admitted to our hospital was selected.They were divided into drug-eluting stent(DES)group(n=78)and drug-coated balloon(DCB)group(n=88).The therapeutic effect,restenosis(ISR)and adverse events of two groups were observed.Results:The narrowest diameter,lesion length and diameter stenosis rate of DCB group were signifi-cantly improved after treatment(DCB group:t=32.963,3.420,28.346;DES group:t=17.613,2.089,9.862;P<0.05);the narrowest diameter,lesion length and diameter stenosis rate of DCB group were better than DES group after treatment(t=7.672,2.593,8.619,P<0.05).At the end of follow-up,ISR was found in some cases in both groups.The progression rate in DES group was higher than that in DCB group(χ^2=34.901,P<0.05),while the maintenance and improvement rate was lower than that in DCB group(χ^2=18.769,8.448,P<0.05).The incidence of adverse events in DES group(25.6%)was higher than that in DCB group(14.8%),but there was no significant difference between two groups(χ^2=3.067,P>0.05).Conclusions:DCB is superior to DES in coronary artery SVD,while reducing the long-term ISR and no signifi-cant increase in adverse events.