药物涂层球囊在冠状动脉支架内再狭窄介入治疗中的应用价值分析

Application value analysis of drug-coated balloon in interventional treatment of in-stent restenosis of coronary artery

目的探讨冠状动脉支架内再狭窄(ISR)患者经皮冠状动脉介入(PCI)治疗中应用药物涂层球囊(DCB)的价值。方法60例冠状动脉ISR患者,采用双色球法分为对照组和观察组,每组30例。所有患者均接受PCI治疗,对照组采用合适的药物涂层支架(DES)处理,观察组采取紫杉醇DCB处理。比较两组患者手术前后靶病变管腔直径、靶病变管腔狭窄率、生活质量以及治疗费用、心血管不良事件发生率。结果术后半年,观察组靶病变管腔直径(2.37±0.34)mm大于对照组的(1.86±0.27)mm,靶病变管腔狭窄率(12.05±1.35)%低于对照组的(17.16±2.14)%,差异具有统计学意义(P<0.05)。术后半年,观察组生理评分(64.41±3.57)分、心理评分(63.78±3.65)分、社会关系评分(66.32±4.31)分、环境评分(69.51±4.56)分均高于对照组的(56.84±4.76)、(56.82±4.76)、(57.48±5.44)、(59.23±5.38)分,差异具有统计学意义(P<0.05)。两组日均费用、耗材费用、住院总费用比较,差异均无统计学意义(P>0.05)。随访半年,观察组心血管不良事件发生率6.67%低于对照组的33.33%,差异具有统计学意义(P<0.05)。结论冠状动脉ISR患者PCI治疗中应用DCB,与DES方案比较,可更好地改善靶病变管腔狭窄情况,同时更好地减少随访期间心血管不良事件的发生,促进患者术后生活质量提升,值得应用。

Objective To discuss the value of drug-coated balloon(DCB)in percutaneous coronary intervention(PCI)for patients with in-stent restenosis(ISR)of coronary artery.Methods A total of 60 patients with ISR of coronary artery were divided into control group and observation group by two-color ball method,with 30 cases in each group.All patients were treated with PCI,the control group received appropriate drug-eluting stent(DES),while the observation group received paclitaxel DCB treatment.Both groups were compared in terms of lumen diameter of target lesion,lumen stenosis rate of target lesion and quality of life before and after surgery,as well as treatment cost and incidence of cardiovascular adverse events.Results At 6 months after surgery,the lumen diameter of the target lesion of(2.37±0.34)mm in the observation group was higher than that of(1.86±0.27)mm in the control group,and the lumen stenosis rate of the target lesion of(12.05±1.35)%was lower than that of(17.16±2.14)%in the control group.The differences were statistically significant(P<0.05).At 6 months after surgery,the observation group had physiological score of(64.41±3.57)points,psychological score of(63.78±3.65)points,social score of(66.32±4.31)points and environmental score of(69.51±4.56)points,which were higher than those of(56.84±4.76),(56.82±4.76),(57.48±5.44)and(59.23±5.38)points in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in average daily cost,consumables cost and total hospitalization cost between the two groups(P>0.05).After 6 months of follow-up,the incidence of cardiovascular adverse events in the observation group was 6.67%,which was lower than that of 33.33%in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with DES,the application of DCB in PCI treatment of patients with ISR of coronary artery can better improve the lumen stenosis of target lesions,better reduce the occurrence of cardiovascular adverse events during follow-up,and promote the improvement of postoperative quality of life of patients,which is worthy of application.