药物涂层球囊联合血管减容对下肢动脉硬化闭塞病变病人血运重建率、血管内皮功能及踝肱指数的影响

Effect of drug-coated balloon combined with vascular volume reduction on revascularization rate,vascular endothelial function and ankle-brachial index in patients with lower extremity arteriosclerotic occlusive disease

目的观察药物涂层球囊(DCB)联合血管减容对下肢动脉硬化闭塞病变(LEAOD)病人血运重建率、血管内皮功能及踝肱指数(ABI)的影响。方法选择2018年6月至2021年6月黄河三门峡医院收治的LEAOD病人100例,按随机数字表法分两组,对照组(n=50)予DCB,研究组(n=50)予DCB联合血管减容。比较靶血管通畅率、靶血管血运重建(TLR)率、再狭窄率、Rutherford分级情况、血管内皮功能、ABI、下肢动脉最小管腔直径(MLD)、晚期管腔丢失(LLL)值。结果术后12个月,研究组靶血管通畅率(92.00%,46/50)均较对照组(74.00%,37/50)高(P<0.05)。术后12个月,研究组TLR率(2.00%,1/50)、再狭窄率(0,0/50)均较对照组(18.00%,9/50)、(12.00%,6/50)低(P<0.05)。术后,两组Rutherford分级情况均优于术前(P<0.05),且研究组Rutherford分级情况均优于对照组(Z=-2.21,P=0.027)。术后个12个月,两组血流介导的血管内皮舒张程度值(FMD)、硝酸甘油介导的血管内皮舒张程度值(NMD)、足背动脉ABI、胫后动脉ABI均高于术前(P<0.05),且研究组高于对照组(均P<0.05)。术后个12个月,两组的下肢动脉MLD、LLL值均低于术后次日(P<0.05),且研究组下肢动脉MLD高于对照组(P<0.05),LLL值低于对照组(P<0.05)。结论DCB联合血管减容能提高LEAOD病人靶血管通畅率,降低TLR率、再狭窄率,改善Rutherford分级情况、血管内皮功能、ABI,调节下肢动脉MLD、LLL值。

Objective To observe the effect of drug-coated balloon(DCB)combined with vascular volume reduction on revasculariza-tion rate,vascular endothelial function and ankle-brachial index(ABI)in patients with lower extremity arteriosclerotic occlusive dis-ease(LEAOD).Methods Data of 100 LEAOD patients,admitted to Huanghe Sanmenxia Hospital from June 2018 to June 2021,were gathered and assigned into two groups according to the random number table method:the control group(n=50)received DCB,while the study group(n=50)received DCB combined with vascular volume reduction.The target vessel patency rate,target lesion revasculariza-tion(TLR)rate,restenosis rate,Rutherford classification,vascular endothelial function,ABI,lower extremity arterial minimum lumen diameter(MLD),and late lumen loss(LLL)values were compared.Results At 12 months after operation,the target vessel patency rate in the study group(92.00%,46/50)was higher than that in the control group(74.00%,37/50)(P<0.05).Meanwhile,the TLR rate(2.00%,1/50)and restenosis rate(0,0/50)of the study group were lower than those of the control group[(18.00%,9/50),(12.00%,6/50),respectively;P<0.05].After operation,the Rutherford classification in both groups was better than that before operation(P<0.05),and the Rutherford classification in the study group was better than that in the control group(Z=-2.21,P=0.027).At 12 months after operation,blood flow-mediated endothelial relaxation degree(FMD),nitroglycerin-mediated endothelial relaxation degree(NMD),dor-sal foot artery ABI,and posterior tibial artery ABI in both groups were higher than those before operation(P<0.05),and the study group higher than the control group(all P<0.05).Meanwhile,the MLD and LLL values of lower extremity arteries in both groups were lower than those the next day after operation(P<0.05),and the MLD of lower extremity arteries in the study group was higher than that in the control group(P<0.05),and the LLL value was lower than that in the control group(P<0.05).Conclusion DCB combined with vascu-lar volume reduction can improve the patency rate of target vessels,reduce TLR rate and restenosis rate,improve Rutherford classifica-tion,vascular endothelial function,and ABI,and regulate lower extremity arterial MLD and LLL values in LEAOD patients.