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两种治疗方案对支架内再狭窄患者冠脉造影效果及临床事件发生风险的影响(1)
http://www.100md.com 2019年8月15日 《中国现代医生》 2019年第23期
     [摘要] 目的 探讨药物洗脱球囊和药物洗脱支架对支架内再狭窄患者冠脉造影效果及临床事件发生风险的影响。方法 选取我院2015年1月~2016年12月收治支架内再狭窄患者共100例为研究对象,根据治疗方案差异随机分为A组(50例)和B组(50例),A组患者采用药物洗脱支架治疗,B组患者采用药物洗脱球囊方案治疗;比较两组患者术后随访晚期管腔丢失量、二次再狭窄率、Mehran再狭窄分型及临床事件发生率。 结果 两组患者晚期管腔丢失量比较,B组晚期管腔丢失量较A组更少(P<0.05),两组二次再狭窄率比较,差异无统计学意义(P>0.05);两组患者Mehran再狭窄分型情况比较,差异无统计学意义(P>0.05);两组患者临床事件发生率比较,差异无统计学意义(P>0.05)。 结论 药物洗脱球囊治疗支架内再狭窄总体疗效不逊于药物洗脱支架,具有临床应用价值。

    [关键词] 药物洗脱球囊;药物洗脱支架;支架内再狭窄;冠脉造影效果;临床事件

    [中图分类号] R543 [文献标识码] A [文章编号] 1673-9701(2019)23-0015-04

    [Abstract] Objective To investigate the effects of drug-eluting balloon and drug-eluting stent on coronary angiography and risk of clinical events in patients with in-stent restenosis. Methods A total of 100 patients with in-stent restenosis were enrolled in our hospital from January 2015 to December 2016. They were randomly divided into group A (50 cases) and group B(50 cases) according to the treatment plan, and the group A was treated with eluting stents, the group B was treated with drug-eluting balloon. The late lumen loss, secondary restenosis rate, Mehran restenosis classification, and clinical event rate were compared between the two groups during the postoperative follow-up. Results The amount of late luminal loss in group B was significantly less than that in the group A(P<0.05). There was no significant difference in the rate of secondary restenosis between the two groups(P>0.05).There was no significant difference in the classification of Mehran restenosis between the two groups(P>0.05). There was no significant difference in the incidence of clinical events between the two groups(P>0.05). Conclusion The drug-eluting balloon is not inferior to the drug-eluting stent in the treatment of in-stent restenosis, and has clinical application value.

    [Key words] Drug-eluting balloon; Drug-eluting stent; In-stent restenosis; Coronary angiography effect; Clinical event

    支架內再狭窄是行经皮冠脉介入治疗术(percutaneous coronary intervention,PCI)后亟需解决问题之一,近年来研究显示,药物洗脱球囊通过将球囊成形和药物洗脱技术相结合,输送球囊导管达病变血管壁内,可达到抑制平滑肌增生和降低狭窄程度的目的[1-2]。但对于支架内再狭窄防治药物洗脱球囊应用仍存在一定争议,不同回顾性研究间结论存在较大差异;部分学者报道其与药物洗脱支架应用比较具有相近临床疗效[3];而另一项研究则表明药物洗脱支架应用在治疗支架内再狭窄方面更具优势[4]。本文旨在探讨药物洗脱球囊和药物洗脱支架对支架内再狭窄患者冠脉造影效果及临床事件发生风险的影响,为治疗方案选择提供相应循证依据,现报道如下。

    1 资料与方法

    1.1 一般资料

    选取我院2015年1月~2016年12月收治的支架内再狭窄患者共100例为研究对象,根据治疗方案差异分为A组(药物洗脱支架组)和B组(药物洗脱球囊组),每组50例;两组患者一般资料比较,差异无统计学意义(P>0.05)。见表1。

    1.2 纳入标准, 百拇医药(余小妹 杨栋 周莉 陈宇凯 王明伟)
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