药物涂层球囊在PCI术后再发急性心肌梗死患者中的应用效果

Application effect of drug-coated balloon in patients with recurrent acute myocardial infarction after PCI

目的探讨药物涂层球囊(DCB)在经皮冠脉介入术(PCI)后再发急性心肌梗死(AMI)患者中的应用效果。方法选择2019年1月至2020年1月收治的36例曾行PCI术后再发AMI的患者进行回顾性分析,根据手术处理方式不同将其分为球囊扩张组(n=20)、药物球囊组(n=16)。球囊扩张组采用顺应性球囊、切割球囊或非顺应性球囊进行扩张治疗,药物球囊组在球囊扩张组的基础上采用DCB治疗。比较两组的主要不良心血管事件(MACE)、心绞痛发生情况、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、靶病变进展及罪犯血管晚期管腔丢失(LLL)情况。结果术后1年,药物球囊组的再梗死、靶病变血管重建发生率均显著低于球囊扩张组,差异具有统计学意义(P<0.05)。药物球囊组术后1年的心绞痛、靶病变进展发生率及罪犯血管LLL明显低于球囊扩张组,差异具有统计学意义(P<0.05)。结论DCB应用于PCI术后再发AMI患者中有很好的临床效果,可降低MACE及心绞痛发生率。

Objective To investigate the application effect of drug-coated balloon(DCB)in patients with recurrent acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods From January 2019 to January 2020,36 patients with recurrent AMI after PCI were selected and analyzed retrospectively.According to different surgical treatment methods,the patients were divided into balloon dilation group(n=20)and drug balloon group(n=16).The balloon dilation group was given compliant balloon,cutting balloon or non-compliant balloon for dilation treatment,and the drug balloon group was treated with DCB on the basis of the balloon dilation group.The main adverse cardiovascular events(MACE),angina pectoris,left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),target lesion progression and late lumen loss(LLL)of criminal vessels were compared between the two groups.Results One year after operation,the incidences of reinfarction and target lesion revascularization in the drug balloon group were significantly lower than those in the balloon dilation group,and the differences were statistically significant(P<0.05).The incidences of angina pectoris,target lesion progression at one year after operation and LLL of criminal vessels in the drug balloon group were significantly lower than those in the balloon dilation group,and the differences were statistically significant(P<0.05).Conclusion DCB applied in patients with recurrent AMI after PCI has a good clinical effect,which can reduce the incidences of MACE and angina pectoris.