Silverhawk斑块旋切结合国产紫杉醇药物涂层球囊与金属裸支架治疗下肢动脉闭塞的疗效分析

Efficacy analysis of silverhawk plaque rotary cutting combined with domestic paclitaxel DCB and bare metal stent in the treatment of patients with lower extremity arterial occlusion

目的探讨Silverhawk斑块旋切、国产紫杉醇药物涂层球囊(DCB)和金属裸支架治疗下肢动脉闭塞的临床疗效。方法前瞻性选取2019年1月~2021年12月我院收治的下肢动脉闭塞病人101例,按照随机对照法将其分为两组,A组进行Silverhawk斑块旋切治疗,B组在A组基础上加以国产紫杉醇DCB+金属裸支架治疗,对两组的临床指标、临床驱动靶病变再次血运重建率、内皮素(ET)-1、一氧化氮(NO)以及血浆P选择素水平进行比较。结果B组病人治疗后的临床指标优于A组,治疗后12小时两组病人的血浆P选择素、ET-1水平降低,治疗后12小时两组病人的NO水平上升,且治疗后B组病人的血浆P选择素、ET-1及NO水平均优于A组,B组病人术后6个月、12个月的再次血运重建率均低于A组,差异均有统计学意义(P<0.05)。结论应用Silverhawk斑块旋切+国产紫杉醇DCB+金属裸支架治疗下肢动脉闭塞的临床疗效显著,改善病人的血管通畅率、ET-1、NO以及血浆P选择素水平,提高其踝肱指数,降低靶病变血流重建率。

Objective This article analyzes the clinical efficacy of silverhawk plaque cyclotomy,Drug-coated balloon(DCB)and bare metal stent in the treatment of patients with lower extremity arterial occlusion.Method A total of 101 patients with lower extremity arterial occlusion admitted to our hospital from January 2019 to December 2021 were prospectively selected and divided into group A for silverhawk plaque rotary cutting treatment by randomized controlled method.Group B was treated with domestic paclitaxel DCB+bare metal stent on the basis of group A,and then its clinical indicators,clinical target lesion revascularization rate,ET-1,NO and plasma P-selectin levels were compared.Results The clinical indexes of group B were significantly better than those of group A(P<0.05).The levels of plasma P-selectin and ET-1 in the two groups were significantly decreased at 12 h after treatment(P<0.05).The levels of NO in the two groups were significantly increased at 12 h after treatment(P<0.05),and the levels of plasma P-selectin,ET-1 and NO in group B were significantly better than those in group A(P<0.05).The revascularization rates at 6 months and 12 months after operation in group B were significantly lower than those in group A(P<0.05).Conclusion Application of silverhawk plaque rotary cutting+domestic paclitaxel DCB+bare metal stent combined treatment of lower extremity arterial occlusion of clinical curative effect is remarkable,improve the patient’s vascular patency rate,ET-1,NO and plasma P-selectin level,improve the ankle brachial index,reduce the target lesion blood flow reconstruction rate,is worth promoting.