药物涂层球囊在冠状动脉分叉病变中的临床应用研究

Clinical Application Study of Drug-coated Balloon in Coronary Bifurcation Lesion

目的:探讨分析药物涂层球囊(DCB)在冠状动脉分叉病变(CBL)患者中的临床应用效果。方法:选取2021年1月—2022年12月新余市人民医院收治的180例CBL患者,按照患者病变类型分为三个亚组,每组60例,其中亚组一为同时存在主支与分支狭窄,亚组二为仅存在主支狭窄,亚组三为仅存在分支狭窄,同时,三个亚组均采用随机数字表法分为支架组与药球组,各30例。亚组一支架组采用双支架技术,药球组采用主支支架、分支DCB技术;亚组二支架组主支采用Provisional T技术,药球组采用主支DCB技术;亚组三支架组分支采用单支架精确定位技术,药球组采用分支DCB技术。所有患者术后均随访12个月。比较各亚组中支架组与药球组术前、术后即刻及随访结束时最小管腔直径(MLD)、狭窄程度,以及随访结束时晚期管腔丢失(LLL)、再狭窄率,并记录主要不良心血管事件(MACE)发生率。结果:各组术后即刻、随访结束时MLD均较术前均增加,狭窄程度均较术前下降,差异均有统计学意义(P<0.05);术后即刻各亚组中药球组与支架组MLD、狭窄程度比较,差异均无统计学意义(P>0.05);随访结束时,各亚组中药球组MLD均大于支架组,狭窄程度均低于支架组,差异均有统计学意义(P<0.05)。随访结束时,各亚组中药球组LLL、再狭窄率均低于支架组,差异均有统计学意义(P<0.05)。各亚组中药球组MACE总发生率均低于支架组,差异均有统计学意义(P<0.05)。结论:DCB在CBL患者中应用效果良好,能有效降低患者术后再狭窄风险,避免再次血运重建,并降低术后MACE发生率。

Objective:To explore and analyze the clinical application effect of drug-coated balloon(DCB)on patients with coronary bifurcation lesion(CBL).Method:A total of 180 patients with CBL admitted to Xinyu People's Hospital from January 2021 to December 2022 were selected and divided into three subgroups according to the disease type,with 60 cases in each group.Subgroup 1 had both main branch and branch stenosis,subgroup 2 had only main branch stenosis,and subgroup 3 had only branch stenosis.The three subgroups were divided into stent group and drug balloon group by random number table method,with 30 cases in each group.The sent group 1 adopted double-stent technique,and the drug balloon group 1 adopted main branch stent and branch DCB technique.The sent group 2 adopted Provisional T technique,and the drug balloon group 2 adopted main branch DCB technique.The sent group 3 adopted single stent precise positioning technique,and the drug balloon group 3 adopted branch DCB technique.All patients were followed up for 12 months after surgery.The minimum lumen diameter(MLD)and degree of stenosis before surgery,after surgery and at the end of follow-up,and late lumen loss(LLL)and restenosis rate at the end of follow-up were compared between the stent group and the drug ball group in all subgroups,and the incidence of major adverse cardiovascular events(MACE)was recorded.Result:The MLD in each group immediately after surgery and at the end of follow-up were increased compared with those before surgery,and the stenosis degree were reduced compared with those before surgery,the differences were statistically significant(P<0.05).There were no statistically significant differences in MLD and stenosis degree among subgroups of drug balloon group and sent group immediately after surgery(P>0.05).At the end of follow-up,the MLD of drug balloon group in each subgroup were higher,and the degree of stenosis were lower than those in sent group,the differences were statistically significant(P<0.05).The LLL and restenosis rate of drug balloon group in each subgroup were lower compared with those in sent group(P<0.05).The total incidence rate of MACE of drug balloon group in each subgroup were lower than those in stent group,the differences were statistically significant(P<0.05).Conclusion:DCB has a good application effect in patients with CBL,which can effectively reduce the risk of postoperative restenosis,avoid revascularization,and reduce the incidence of postoperative MACE.