药物涂层球囊在冠脉支架内再狭窄及小血管病变中的临床应用研究

Clinical application of drug coated balloon in coronary stent restenosis and small vessel disease

目的:观察药物涂层球囊在冠脉支架内再狭窄与小血管病变中的临床应用效果。方法:收集2017年1月—2020年12月期间内蒙古科技大学包头医学院第一附属医院就诊的小血管病变患者49例,分别为小血管病变支架治疗组25例、小血管病变药物涂层球囊治疗组24例;支架内再狭窄患者45例,分别为支架内再狭窄支架治疗组24例、支架内再狭窄药物涂层球囊治疗组21例,比较小血管病变及支架内再狭窄患者分别应用支架或药物涂层球囊的临床治疗效果差异。结果:药物球囊组靶病变术前狭窄程度、术前最小管腔直径、术后即刻狭窄程度、术后即刻管腔狭窄直径、病变长度、参考管腔直径、复查时最小管腔直径与支架组比较差异无统计学意义(P>0.05);药物球囊组复查时狭窄程度低于支架组(P<0.05),不良心血管事件发生率、出血事件发生率也低于支架组(P<0.05)。结论:采用药物涂层球囊治疗冠脉支架再狭窄及小血管病变患者,对复查时血管管腔再狭窄程度有良好的影响,并且能够有效降低不良心血管事件发生率及出血发生率,对改善预后发生积极影响。

Objective:To compare the clinical application effects of drug-coated balloons in coronary in-stent restenosis and small vessel lesions.Methods:Forty-nine cases of small vessel lesions attending the First Affiliated Hospital of Baotou Medical College Inner Mongolia University of Science and Technology during January 2017-December 2020 were collected,25 cases in the small vessel lesion stent treatment group and 24 cases in the small vessel lesion drug-coated balloon treatment group.There were 45 cases of in-stent restenosis lesions,24 cases in the in-stent restenosis stent treatment group and 21 cases in the in-stent restenosis drug-coated balloon treatment group,respectively.Results:We compared the clinical treatment effects of stenting or drug-coated balloons in patients with small vessel lesions and in-stent restenosis,respectively.The preoperative stenosis,preoperative minimum lumen diameter,immediate postoperative stenosis,and in-stent restenosis of the target lesion in the drug-coated balloon group were not statistically significant(P>0.05).The differences in preoperative stenosis,preoperative minimum lumen diameter,immediate postoperative stenosis,immediate postoperative lumen diameter,lesion length,reference lumen diameter,and minimum lumen diameter at the time of review were not statistically significant in the drug balloon group compared with the stent group(P>0.05);the stenosis level at the time of review was lower in the drug balloon group than in the stent group(P<0.05);the incidence of adverse cardiovascular events and bleeding events were lower in the drug balloon group than in the stent group(P<0.05).Conclusion:Treatment of patients with coronary stent restenosis and small vessel lesions with drug-coated balloons has a good effect on the degree of lumen restenosis at the time of review,and can effectively reduce the incidence of adverse cardiovascular events and the incidence of bleeding,which has a positive impact on improving the prognosis.