药物涂层球囊治疗对冠状动脉分叉病变患者的疗效

Therapeutic effect of drug coated balloon therapy on patients with coronary bifurcation lesions

目的:研究药物涂层球囊(DCB)治疗对冠状动脉分叉病变患者的疗效。方法:于我院治疗的100例冠状动脉分叉病变患者被随机均分为支架植入组[经皮冠状动脉介入(PCI)治疗基础上加用裸金属单纯支架植入]与DCB组(PCI治疗基础上加用紫杉醇DCB)。比较两组术前、术后、术后9个月靶病变分支最小管腔内径(MLD)、直径狭窄率,术后9个月晚期管腔丢失(LLL)、再狭窄率、主要不良心血管事件(MACE)、靶病变再次血运重建(TLR)、靶病变失败[Target Lesion Failure(TLF)]、心源性休克、靶血管心肌梗死发生率。结果:与支架植入组比较,DCB组术后MLD[(1.66±0.29)mm比(2.04±0.32)mm]、术后9个月MLD[(1.40±0.46)mm比(1.75±0.53)mm]均显著扩大(P均=0.001)。术后9个月,DCB组再狭窄率(4.0%比18.0%)、MACE发生率(8.0%比24.0%)均显著低于支架植入组(P均<0.05);两组LLL、TLF、心源性休克、靶血管心肌梗死、TLR发生率无显著差异(P均>0.05)。结论:DCB可显著扩大冠状动脉分叉病变患者MDL,降低术后再狭窄率与MACE发生率,安全性高。

Objective:To study therapeutic effect of drug coated balloon(DCB)therapy on patients with coronary bifurcation lesions(CBL).Methods:A total of 100 CBL patients treated in our hospital were randomly and equally divided into stent implantation group[received bare metal stent implantation based on percutaneous coronary intervention(PCI)]and DCB group(received paclitaxel DCB based on PCI).Minimum lumen diameter(MLD)and diameter stenosis rate before,after and nine months after PCI,late lumen loss(LLL),restenosis rate,incidence rates of major adverse cardiovascular event(MACE),target lesion revascularization(TLR),target lesion failure(TLF),cardiogenic shock and target vessel myocardial infarction on nine months after PCI were compared between two groups.Results:Compared with stent implantation group,there were significant increase in MLD after PCI[(1.66±0.29)mm vs.(2.04±0.32)mm]and MLD nine months after PCI[(1.40±0.46)mm vs.(1.75±0.53)mm]in DCB group(P=0.001 all).Nine months after PCI,restenosis rate(4.0%vs.18.0%)and incidence rate of MACE(8.0%vs.24.0%)of DCB group were significantly lower than those of stent implantation group(P<0.05 all);there were no significant difference in LLL,incidence rates of TLF,cardiogenic shock,target vessel myocardial infarction and TLR between two groups(P>0.05 all).Conclusion:DCB can significantly increase MDL,reduce postoperative restenosis rate and incidence rate of MACE with high safety in CBL patients.