| 摘要: |
| ［摘要］ 目的 比较不同预处理球囊在药物涂层球囊治疗冠状动脉病变中的临床应用效果。方法 招募2020年10月至2021年10月沧州市人民医院收治的冠心病心绞痛患者150例，采用随机数字表法将其分为非顺应性球囊组、棘突球囊组和切割球囊组，每组50例。在放置药物球囊治疗前分别给予非顺应性球囊、棘突球囊、切割球囊预处理。于术前、术后即刻，以及术后6个月、12个月分别行冠脉造影检查，比较三组介入治疗成功率、手术时间、球囊一次性通过率、弹性回缩率、病变血管最小内径、冠脉狭窄率、靶血管再狭窄，以及术后即刻心肌梗死溶栓治疗分级（TIMI）3级、血管夹层、紧急靶血管重建和主要心血管不良事件（MACE）发生情况。结果 切割球囊组术后即刻，以及术后6个月、12个月的介入治疗成功率高于非顺应性球囊组和棘突球囊组（P<0.017）。切割球囊组术后即刻TIMI 3级比例高于非顺应性球囊组和棘突球囊组（P<0.017）。切割球囊组弹性回缩率、血管夹层和紧急靶血管重建发生率均显著低于非顺应性球囊组（P<0.017或P<0.05），但切割球囊组球囊一次性通过率低于非顺应性球囊组和棘突球囊组（P<0.017），切割球囊组手术时间长于非顺应性球囊组和棘突球囊组（P<0.05）。三组术后病变血管最小内径逐渐减少，冠脉狭窄率逐渐增加，切割球囊组术后6个月、12个月的病变血管最小内径大于非顺应性球囊组和棘突球囊组，冠脉狭窄率低于非顺应性球囊组和棘突球囊组，差异有统计学意义（P<0.05）。切割球囊组靶血管再狭窄、MACE发生率显著低于非顺应性球囊组（P<0.017）。结论 与非顺应性球囊和棘突球囊比较，切割球囊预扩张可降低血管夹层发生率和弹性回缩率，提高冠脉介入治疗的即时效果并维持病变管腔通畅，降低靶血管再狭窄和MACE发生风险。 |
| 关键词: 药物涂层球囊 冠状动脉病变 非顺应性球囊 棘突球囊 切割球囊 |
| DOI：10.3969/j.issn.1674-3806.2023.09.10 |
| 分类号:R 543.3 |
| 基金项目:沧州市重点研发计划项目（编号：213106018） |
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| Comparison of clinical application effects of different pretreatment balloons on treatment of coronary artery disease with drug-coated balloon |
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ZHAO Dian-ru, GE Mei-qin, SHEN Qiao-li, et al.
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The Third Department of Cardiology, Cangzhou People′s Hospital, Hebei 061000, China
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| Abstract: |
| ［Abstract］ Objective To compare the clinical application effects of different pretreatment balloons on treatment of coronary artery disease with drug-coated balloon(DCB). Methods One hundred and fifty patients with angina pectoris of coronary artery disease who were admitted to Cangzhou People′s Hospital from October 2020 to October 2021 were recruited and divided into non-compliant balloon group, spinous balloon group and cut balloon group by random number table method, with 50 cases in each group, and non-compliant balloon, spinous balloon and cut balloon were pretreated in the three groups respectively before DCB was placed. Coronary angiography was performed before operation, immediately after operation, and 6 and 12 months after operation. The success rate of interventional therapy, operation time, one-time balloon passing rate, elastic retraction rate, minimum inner diameter of the lesion vessel, coronary stenosis rate, target vessel restenosis, thrombolysis in myocardial infarction(TIMI) grade 3 immediately after operation, vascular dissection, emergency target vessel reconstruction and major adverse cardiovascular events(MACE) were compared among the three groups. Results The success rate of interventional therapy in the cut balloon group was higher than that in the non-compliant balloon group and the spinous balloon group immediately after operation, and 6 and 12 months after operation(P<0.017). The proportion of TIMI grade 3 immediately after operation in the cut balloon group was higher than that in the non-compliant balloon group and the spinous balloon group(P<0.017). The incidence rates of elastic retraction, vascular dissection and emergency target vessel reconstruction in the cut balloon group were significantly lower than those in the non-compliant balloon group(P<0.017, P<0.05), but the one-time balloon passing rate in the cut balloon group was lower than that in the non-compliant balloon group and the spinous balloon group(P<0.017). The operation time in the cut balloon group was longer than that in the non-compliant balloon group and the spinous balloon group(P<0.05). The minimum inner diameter of the lesion vessel in the three groups decreased gradually, and the coronary stenosis rate increased gradually. The minimum inner diameter of the lesion vessel in the cut balloon group was larger than that in the non-compliant balloon group and the spinous balloon group 6 and 12 months after operation, and the coronary stenosis rate in the cut balloon group was significantly lower than that in the non-compliant balloon group and the spinous balloon group(P<0.05). The incidence rates of target vessel restenosis and MACE in the cut balloon group were significantly lower than those in the non-compliant balloon group(P<0.017). Conclusion Compared with that of non-compliant balloon and spinous balloon, the predilation of cut balloon can reduce the incidence of vascular dissection and elastic retraction rate, and improve the immediate effect of coronary intervention, and maintain the patency of the lesion lumen, and reduce the risk of target vessel restenosis and MACE. |
| Key words: Drug-coated balloon Coronary artery disease Non-compliant balloon Spinous balloon Cut balloon |
