药物涂层球囊与普通球囊扩张术对冠心病支架内再狭窄患者近远期预后的影响

Effect of Drug-Coated Balloon and Ordinary Balloon Dilatation on Short-Term and Long-Term Prognosis in Patients with Coronary HeartDisease and In-stent Restenosis

目的探讨分析药物涂层球囊(DCB)与普通球囊扩张术对冠心病支架内再狭窄患者近远期预后的影响。方法筛选商丘市第一人民医院2021年1月至2022年1月收治的120例经介入治疗后冠状动脉支架内再狭窄的冠心病患者,按照随机数字表法将患者分为DCB组和普通组,各60例,DCB组接受药物涂层球囊治疗,普通组接受普通球囊扩张术治疗。比较治疗后两组患者的扩张成功率和心肌标志物[肌酸激酶同工酶(CK-MB)、肌钙蛋白T]、术后即刻最小管腔直径和随访12个月后的晚期管腔丢失、支架内再狭窄发生率、主要心血管不良事件(MACE)发生率(脑卒中、心力衰竭、非致死性心肌梗死)。结果治疗后,DCB组的扩张成功率(95.00%)高于普通组(83.33%),差异有统计学意义(P<0.05);治疗后,DCB组CK-MB为(12.86±2.45)U·L^(-1)、肌钙蛋白T为(0.12±0.02)μg·L^(-1),均较普通组的(15.45±2.48)U·L^(-1)、(0.22±0.04)μg·L^(-1)下降明显(P<0.05);DCB组的术后即刻最小管腔直径为(2.45±0.12)mm,相较于普通组的(2.06±0.04)mm更大(P<0.05);经过12个月的随访复查冠脉造影,DCB组的晚期管腔丢失为(0.26±0.04)mm,明显小于普通组的(0.38±0.08)mm(P<0.05);随访12个月后,DCB组的支架内再狭窄发生率(5.00%)低于普通组(16.67%)(P<0.05);DCB组MACE发生率(16.67%)与普通组(33.33%)相比更低(P<0.05)。结论药物涂层球囊治疗冠心病患者冠状动脉支架内再狭窄的临床效果比普通球囊扩张术更好,晚期管腔丢失较少,支架内再狭窄率较低,且MACE发生率也显著降低。

Objective To explore and analyze the effect of drug-coated balloon(DCB)and ordinary balloon dilatation on short-term and long-term prognosis in patients with coronary heart disease and in-stent restenosis.Methods A total of 120 patients with coronary artery disease and in-stent restenosis after interventional therapy in the First People’s Hospital of Shangqiu from January 2021 to January 2022 were selected and divided into DCB group and ordinary group,with 60 cases in each group by the random number table method.The DCB group was treated with DCB while the ordinary group was given ordinary balloon dilatation.The dilatation success rate and myocardial markers[creatine kinase myocardial band(CK-MB),troponin T]after treatment,minimum lumen diameter immediately after surgery,late lumen loss,incidence rate of in-stent restenosis and incidence rates of major adverse cardiovascular events(MACE)(cerebral stroke,heart failure,nonfatal myocardial infarction)after 12 months of follow-up were compared between the two groups.Results After treatment,the success rate of dilatation in DCB group(95.00%)was higher than that in ordinary group(83.33%)(P<0.05).After treatment,the levels of CK-MB and troponin T in DCB group were(12.86±2.45)U·L^(-1) and(0.12±0.02)μg·L^(-1),which were lower compared with(15.45±2.48)U·L^(-1) and(0.22±0.04)μg·L^(-1) in ordinary group(P<0.05).The minimum lumen diameter immediately after surgery in DCB group was longer than that in ordinary group[(2.45±0.12)mm vs(2.06±0.04)mm](P<0.05).After 12 months of follow-up review of coronary angiography,the late lumen loss with(0.26±0.04)mm in DCB group was lower than(0.38±0.08)mm in ordinary group(P<0.05).The incidence rate of in-stent restenosis in DCB group(5.00%)after 12 months of follow-up was lower than that in ordinary group(16.67%)(P<0.05).The total incidence rate of MACE in DCB group(16.67%)was lower than that in ordinary group(33.33%)(P<0.05).Conclusion Drug-coated balloon in the treatment of coronary artery in-stent restenosis in patients with coronary artery disease has a better clinical effect,less late lumen loss,lower incidence rate of in-stent restenosis and more significantly reduced MACE than ordinary balloon dilatation.