药物涂层球囊与经皮腔内球囊扩张对2型糖尿病膝下动脉病变患者一期通畅率、动脉内氧化应激的影响

Effects of drug-coated balloon and percutaneous intraluminal balloon dilation on first-stage patency rate and intra-arterial oxidative stress in patients with T2DM infra-knee artery disease

目的:探讨药物涂层球囊与经皮腔内球囊扩张对2型糖尿病(T2DM)膝下动脉病变患者一期通畅率、动脉内氧化应激的影响。方法:选取2017年6月至2019年2月在我院诊治的T2DM膝下动脉病变患者134例作为研究对象,以随机数字表法分为对照组与研究组,每组67例。对照组给予经皮腔内球囊扩张治疗,研究组给予药物涂层球囊治疗。比较两组术中情况、运动能力及术前、术后6个月管腔相关指标、踝肱指数(ABI)、动脉血氧化应激水平变化和治疗效果和并发症情况。结果:研究组与对照组手术时间、扩张时间、射线时间、最大扩张压力、对比剂用量差异均无统计学意义(P>0.05)。术后6个月,研究组6分钟步行试验、行走障碍改善率均优于对照组(P<0.05);两组术后管腔狭窄率较术前均降低、最小管腔直径、ABI评分较术前均升高(P<0.05),但两组术后6个月管腔狭窄率、最小管腔直径、ABI评分比较差异无统计学意义(P>0.05)。术后6个月对照组超氧化物歧化酶(SOD)较术前降低;研究组与术前比较差异无统计学意义(P>0.05),但术后明显高于对照组(P<0.05);术后6个月对照组丙二醛(MDA)较术前升高(P<0.05);研究组与术前比较差异亦无统计学意义(P>0.05),但术后明显低于对照组(P<0.05)。随访1年,研究组一期通畅率高于对照组(94.03%vs 88.06%,P>0.05);再狭窄率显著低于对照组(9.52%vs 40.68%,P<0.05)。研究组靶病变处血运重建率改善情况高于对照组,但差异无统计学意义(63.49%vs 55.93%,P>0.05)。结论:药物涂层球囊可明显减轻T2DM膝下动脉病变患者的应激反应,改善运动能力,降低再狭窄率。

Objective-To explore the effect of drug-coated balloon and percutaneous transluminal balloon dilation on the first-stage patency rate and ultra-arterial oxidative stress in patients with type 2 diabetes(T2DM) infra-knee artery disease.Methods:134 patients with T2DM infra-knee artery disease diagnosed and treated in our hospital from June 2017 to Februalry 2019 were selected as the research object.They were randomly divided into the control group and the study group with 67 cases each.For the treatment of internal balloon dilatation,the study group was given drug-coated balloon therapy to compare the intraoperative situation,exercise ability,treatment effect and complications of the two groups,as well as the lumen-related indicators,ankle brachial before and after 6 months Index(ABI),the change in arterial blood oxidative stress level.Results:The operation time,dilation time,radiation time,maximum dilation pressure,contrast agent dosage difference was notstatisticallysignificant(P>0.05);6 months after operation,the study group6-minute walk test(6 MWT),walking disorder improvement rate was significantly higher than that of the control group(P<0.05);the 1-stage patency rate of the study group was followed up,the rate of postoperative lumen stenosis in both groups was lower than before surgery,and the minimum lumen diameter and ABI score were higher than before surgery(P<0.05).The difference between the two groups was not statistically significant(P>0.05);the superoxide dismutase(SOD) of the control group decreased 6 months after operation compared with preoperative(P<0.05),the study group was significantly higher than that of the control group(P<0.05);malondialdehyde(MDA) in the control group increased 6 months after the operation compared with preoperative(P<0.05),the study group was significantly lower than the control group(P<0.05).1 year(94.03% vs 88.06%,P>0.05) was higher than the control group,restenosis rate(9.52% vs 40.68%,P<0.05) was significanylower than the control group;the revascularization rate of the target lesion in the study group improved.It is higher than the control group(63.49% vs 55.93%,P>0.05).Conclusion:The drug-coated balloon can significantly reduce the stress response of T2DM patients with infra-knee artery disease,improve exercise ability,and reduce the rate of restenosis.