准分子激光消蚀术在药物球囊扩张成形术治疗冠状动脉粥样硬化性心脏病中的应用

Application of excimer laser coronary atherectomy in treatment of coronary atherosclerotic heart disease by drug-coated balloon dilatation

目的:探讨准分子激光消蚀术(ELCA)在药物球囊扩张成形术(DCB)治疗冠状动脉粥样硬化性心脏病(简称冠心病)中的应用价值。方法:选取2020年5月至2022年5月诊治的86例冠心病患者作为研究对象,采用随机数排秩法分为观察组(予以DCB联合ELCA治疗)与对照组(予以单纯DCB治疗),各43例。对比2组治疗前后肌酸激酶同工酶(CK-MB)、肌钙蛋白Ⅰ(cTnⅠ)、B型脑钠肽(BNP)、氨基末端脑钠肽前体(NT-proBNP)、小而密低密度脂蛋白(sd-LDL)、生长分化因子15(GDF-15)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)以及治疗后1 a内主要心血管不良事件(MACE)发生率。结果:治疗后观察组CK-MB、cTnⅠ、BNP、NT-proBNP、sd-LDL、GDF-15、LVESD、LVEDD降低的程度,LVEF升高的程度,均大于对照组(P<0.05)。观察组治疗后1 a内MACE发生率低于对照组(P=0.019)。结论:ELCA联合DCB治疗冠心病效果显著,有利于改善心功能和减轻心肌损伤,并降低MACE发生率。

Aim:To investigate the application of excimer laser coronary atherectomy(ELCA)in the treatment of coronary atherosclerotic heart disease(CAD)by drug-coated balloon dilatation(DCB).Methods:A total of 86 patients with CAD diagnosed and treated from May 2020 to May 2022 were selected and allocated into observation group(treated with DCB combined with ELCA)and control group(treated with DCB alone)according to the random number ranking method,with 43 cases in each group.Creatine kinase isoenzyme(CK-MB),cardiac troponinⅠ(cTnⅠ),brain natriuretic peptide(BNP),N-terminal pro-brain natriuretic peptide(NT-proBNP),small dense low-density lipoprotein(sd-LDL),growth differentiation factor-15(GDF-15),left ventricular end systolic dimension(LVESD),left ventricular ejection fraction(LVEF),left ventricular end diastolic dimension(LVEDD)and major adverse cardiovascular event(MACE)were recorded.Result:After treatment,the decrease degree of CK-MB,cTnⅠ,BNP,NT-proBNP,sd-LDL,GDF-15,LVESD and LVEDD,and the increase degree of LVEF in observation group were larger than those in control group(P<0.05).The incidence of MACE in observation group was lower than that in control group(P=0.019).Conclusion:ELCA combined with DCB is effective in the treatment of CAD,which is conducive to improving cardiac function,alleviating myocardial injury,and reducing the incidence of MACE.