药物球囊与药物洗脱支架在急性心肌梗死急诊PCI患者中的应用效果

Application Effect of Drug-coated Balloon and Drug-eluting Stent in Acute Myocardial Infarction Emergency PCI Patients

目的:观察药物球囊(DCB)与药物洗脱支架(DES)在急性心肌梗死(AMI)急诊经皮冠状动脉介入术(PCI)患者中的应用效果。方法:回顾性分析2019年1月-2020年12月于本院行急诊PCI治疗的104例AMI患者的临床资料,依据治疗方法的不同将其分为DCB组(52例)与DES组(52例)。DCB组采用DCB治疗,DES组采用DES治疗。统计两组术中冠脉夹层发生率、心肌梗死溶栓试验(TIMI)分级、住院期间主要不良心血管事件(MACE)及出血事件发生情况。结果:DCB组术中冠脉夹层发生率(15.38%)高于DES组(1.92%),差异有统计学意义(P<0.05),但DCB组术中冠脉夹层多为B型以下;两组TIMI分级、MACE发生率及出血事件发生率对比,差异无统计学意义(P>0.05)。结论:AMI急诊PCI患者采用DCB或DES治疗均安全有效,虽然DCB治疗中冠脉夹层发生率较高,但多为B型以下,临床可根据患者具体情况选择最适宜的治疗方式。

Objective:To observe the application effect of drug-coated balloon(DCB)and drug eluting stent(DES)in emergency percutaneous coronary intervention(PCI)patients with acute myocardial infarction(AMI).Method:The clinical data of 104 patients with AMI who underwent emergency PCI treatment in our hospital from January 2019 to December 2020 were retrospectively analyzed,and they were divided into DCB group(52 cases)and DES group(52 cases)according to the different treatment methods.The DCB group was treated with DCB,and the DES group was treated with DES.The incidence of intraoperative coronary artery dissection,thrombolysis test for myocardial infarction(TIMI)grading,major adverse cardiovascular events(MACE)and bleeding events during hospitalization were counted in the two groups.Result:The incidence of intraoperative coronary dissection in the DCB group(15.38%)was higher than 1.92%in the DES group,and the difference was statistically significant(P<0.05),but intraoperative coronary dissection in DCB group was mostly below type B.There were no significant differences in TIMI grading,MACE incidence and bleeding events incidence between the two groups(P>0.05).Conclusion:Both DCB and DES are safe and effective for AMI patients with emergency PCI.Although the incidence of coronary artery dissection is high in DCB treatment,most of them are below type B,and the most appropriate treatment can be selected according to the specific conditions of the patient.